Unfortunately, many veterans and active members find themselves left behind when it comes to access to affordable testosterone therapy. We're discussing how we will improve access to care for active military and veterans, and why we feel it is important.



TRT is a major therapy that can improve the lives of many of the active military and veterans in the USA. This video is an effort to change that by discussing the importance of TRT and how it can help to unlock your potential.


This editable transcript was computer generated and might contain errors. People can also change the text after it was created.

Brian Mckinley: Yeah, this is Brian from Alpha MD. I'm here today with Garrett, one of our main providers. He's the medical director here as well. We're talking about veterans today, and essentially how poor we think the care for them is especially when it comes to TRT. We have had a lot of active military members and veterans come to us who transfer their care from specifically the VA itself or from other civilian structures that just were not really willing to help them with their trkey concerns. And It's not just small things, it's that they've been really. Treated poorly and almost.

Brian Mckinley: Humiliated for their desire to have actual hormone levels. So we have a lot of examples of that that we'll talk about today, just to kind of go over our thinking on it. But, first and foremost, what we're going to say is, as of today, we're going to be starting a discount for all veterans, and that's going to be a flat 20% discount on all of our services & baseline medications. if you've been following us for a while, that we do a monthly fee that's going to be 20% off that as well. So we think that, a lot of the time is veterans or active military members have a hard time finding medical coverage and we're hoping that this helps them and enables them to find the TRT that they really truly need. Because we feel passionately about it, not being right to really disrespect current and past service members.

Brian Mckinley: So that said, when we talk about some of the examples of why we feel this way, maybe Garrett if you want to Share some recent experiences you had as to why we feel this way yourself.

Garrett Soames: It's interesting because I am an actual contractor for the VA. So just this very morning I was treating veterans at the VA and so it's an interesting experience kind of working kind of out in the community and then working in the VA setting because they're very drastically Mainly the main difference honestly with the VA which again in a lot of ways is a great system. I'm not gonna knock it completely. However, there are much more strict guidelines follow with treatment protocols when it comes to the VA in veterans in particular, they're

Garrett Soames: Trying to save money and I get it that, the VA is trying to make sure that, care is distributed amongst a very large pool of people. However, that also technically leaves means that they're gonna be very stringent on, specific guidelines. You must meet these very specific guidelines in order to pay for a treatment. And so unfortunately one of those treatments that Follows those guidelines. I think a little bit too strictly is in particular working specifically within the veteran population that I'm working at. Now, they're pretty much all, 65 and older. A lot of them actually would benefit from TRT, they're losing energy muscle mass, things like that.

Garrett Soames: And almost all of them qualify they've got low numbers across the board, but even just getting the test. Sometimes is not covered. They won't even allow me to test for low testosterone, And it's an interesting thing. working in where insurance companies VA or Medicare, or whoever They are essentially your boss, whether you're with your doctor PA and respect, or you don't work for the hospital, you work for the insurance companies because they're the ones who pay you. Right? They pay the hospital and…

Garrett Soames: then they pay you and the hospital pays you. But if you really think about it, you're employed by the insurance company. and they get to dictate the care that's given to the patient because they are the ones that are paying so,

Brian Mckinley: And that when it comes to the government, that's essentially one in the same at that point, right?

Garrett Soames: Yeah. Yeah. I mean again I'm not knocking the VA because they've made some drastic improvements over the last decade or so they were really abysmal before they've made. Leaps and bounds. As far as improving the care, they give veterans, which is great. But at the same time, again, they've sort of made this 180 very recently and in particular with opiates, because fortunately They were essentially writing opiate scripts left and right. Can cause a lot of addiction. And you can see it in the homeless veteran population. A lot of them essentially became addicted because of the pills that were prescribed legitimately by their doctors, And so they tried to rein in their controlled substances, which of course includes testosterone.

Brian Mckinley: Yeah, that very frequently happened so it really tied together. Even some of the legislation happening right now, in the rest of the country is really hurting the TRT service. Just outside of the legality and the finance side of it. We've just had so many veterans come to us with core experiences when seeking TRT care, not just denial.

Brian Mckinley: But outright ridicule, they have to get it approved, they have to go see someone for it if you don't have the tests covered like Garrett was saying and when you finally do get to talk to someone about it, if your ranges are what we would consider treatable and low. If they're not super essentially abysmal, we've had patients, get talked to buy endocrinologists sometimes sometimes female and essentially just call them users Laugh at them and tell them essentially, Get out of the office. you're just trying to get steroids or something like that, and I don't know. It really bothers me that people especially who have served the country are treated that way.

Brian Mckinley: When it really doesn't need to go that far. If you just say, We're not going to cover it. That's one thing but it is a surprisingly common occurrence that they get the ridicule with the denial of care and so we just really hope that This discount helps us treat those service members who otherwise wouldn't be able to afford it if they're on a fixed income or something like that. Or, I don't think any other Cherokee company in the market does it right now. So, we're hoping that we end up making a difference for those in the military.

Brian Mckinley: and so if you have any questions about the discount that we're doing, if you have any questions about care, or you want to share some of your personal experiences with healthcare in the military, leave a comment below and tell us about it. We can talk back and forth with you, come to our website, send us a message, ask some questions, we'd love to hear from you and work with you. So yeah, thanks for watching today, and we hope to connect with more veterans and active military members soon. Thank you.

Unlock Your Potential: Major Military Discount on TRT for Veterans & Active Members

We'll discuss the long-term benefits of testosterone therapy and explain the different types of testosterone injections available. Scar tissue may actually be a good thing for muscle strength. 



In this video, I'm discussing the benefits of testosterone injections and testosterone therapy for those looking to increase muscle strength and libido. We'll cover topics like long-term testosterone therapy benefits, testosterone injections for muscle growth through scar tissue build up.


Brian Mckinley: Hello, this is Brian from Alpha MD. Welcome back and today I'm with Garrett. We're going to have a discussion a little bit about scar tissue in muscles. Or both TRT users and previous steroid. Users people who do a lot of intramuscular injections. We have a couple of really interesting, thought processes behind this, and some personal experiences, so, I'm user Garrett's a TRT user.

Brian Mckinley: what's been your experience Garrett with? what you do? What you've done the areas you've injected. And what if you kind of noticed for your long-term TRT use and if you I don't know, get scar tissue or not. What's your take on it?

Garrett Soames: I mean, that was one of the things that kind of scared me the most about starting. TRT is the injections themselves before I started TRT. I worked in the emergency room for years. and I on a daily basis would see Heroin users, coming in with infections from the injection sites and so I guess since that was what I was seeing on a daily basis I was scared. how long is it gonna be until I get an infection or an abscess or whatever from injections, right? And

Garrett Soames: and so that was my biggest fear is it's only gonna be a matter of time until I get an infection right, But, I kind of worked through that fear and never really had to deal with that. And, I guess it was an irrational fear because again, heroin is not sterile right, And

Brian Mckinley: No, no, that's not illegal thing made in a pharmacy, right? So,

Garrett Soames: Right, so they're injecting stuff that's from the street and so I just wasn't kind of taking that next step when my thought process and you're like this is of coming from a pharmacy. This is sterile, and as you alcohol,…

Garrett Soames: the skin ahead of time, all is all as well. so that was my biggest fear for myself and overcoming how long is it going to be before I get an infection and

Garrett Soames: so that was but it's been More than 10 years. Now I think it's been on TRT and it's you said I've certainly got to the point where I do have some scar tissue from injects.

Brian Mckinley: I do too. I've been on it for I don't know, five or six years and I think I can certainly tell a difference. between the muscles that I genuinely injected to pretty often and those I don't

Brian Mckinley: I wouldn't say that it's a negative at least for me. I kind of feel like For whatever reason. Because I always do the same muscles. And I do cycle the areas those muscles. Almost seem bigger bulkier and maybe in some cases stronger than they would be. Otherwise I was kind of worried that scar tissue meant no the muscles gonna get all messed up and be Over a long enough period of time, but as someone who doesn't really love doing a lot of leg work and squats because I used my legs for injections pretty often I'd say that I probably have more strength there than I should. And it might be because of the injections being in that area That's very personal perspective.

Garrett Soames: I guess I've sort of had that same thought process too because I usually use the ventralateral glutes, as my injection site.

Garrett Soames: I definitely noticed, maybe an increase in size and my glutes and particular the ventilateral region. and so I guess it's possible. I don't know if there's any, real scientific studies to prove it one way or the other, but I think colloquially speaking. It makes sense if that's the spot where you're injecting androgens. Than the adjacent tissues will be the first to uptake it, right?

Garrett Soames: So those receptors are going to be the most saturated because they're the most adjacent and then it will spread through the body from there. So that makes some sense. I guess in my mind that You could actually inject specific muscles and those muscles might actually grow a slightly faster than the body.

Brian Mckinley: I actually had a thought of Wow, I did this for my legs. I kind of want some bigger shoulders. What if I started injecting into my deltoids for a while? Same everything but I wouldn't hate that I have had that thought ever…

Brian Mckinley: since I have never felt the negatives, the fear and never seemed founded for me. And like you said, I don't think I've ever really encountered. an issue with any type of infections because again it's all sterile but I will say

Brian Mckinley: The body definitely reacts outside of the size. I think I have noticed increased veins in the areas that I do inject over time and I don't really know why, but they're there.

Brian Mckinley: Yeah, and I guess they kind of I don't know. Do you think it's founded that if you inject into certain areas too often that they may Get so built up on scar tissue that it may impede the function of the muscle. Or what's your opinion on that favorite scene? Anything like that?

Garrett Soames: Yeah. again, one patient that does come to mind. I did see a patient who came into the ER, And he had swelling and redness and pain at an injection site. In his glute in his. And he admitted to me that he used the legal steroids, and he purchased the batch from China and had it delivered to him. Anyways. Yeah, He developed an infection in the injection site and due to the area and I was concerned. on the amount of swelling, I ended up doing a CT scan of the area so I could get a better look inside and see. What's the extent to this infection?

Garrett Soames: In the scan he did have, an abscess for sure. But what was interesting is, The scan included both sides and I could see almost like a cobweb of scar tissue in the ventilateral glutes in the area that he had been injecting again and again, for years and years. So, yes, I think you can say with 100% certainty that, the nature of sticking a needle into, any tissue muscle or…

Garrett Soames: not, you're gonna develop some scar tissue over time. But to look at the scan It was an extensive amount of scar tissue, but the guy had no loss of function. He was a very muscular thick guy. I think even while I was draining his abscess we were just chatting about weight lifting and bodybuilding and he was It's quite like 450 and…

Garrett Soames: it so, To have this amount of, scar tissue through the glutes, which obviously, are needed for squats. Yeah, you.

Garrett Soames: He had no loss of strength despite the extensive scar tissue, he had. so I definitely seen visually on a scan this scar tissue does develop with repetitive injection of the muscles. But it was also that same experience that made me think. does it matter does a scar tissue cause function loss of strength?

Brian Mckinley: Yeah, because you've been on it for, like I said, 10 years and you've done ton of ejections and you've never really felt any of that yourself, right?

Garrett Soames: No, no, here's the thing about it, If a scar tissue in muscle is generally not a big deal, in fact, if you really break it down, What is bodybuilding? What is hypertrophy? it's causing micro tears. tiny thousands, and thousands of tiny little tears. That scar back together.

Garrett Soames: And then that scar tissue was thicker, more fibrous. And creates increase in muscle size.

Garrett Soames: Interestingly, increase in strength and contractile strength, right? Scar tissue is not weaker.

Garrett Soames: It's in technically scar tissue is stronger. then the native tissue was

Brian Mckinley: So, maybe it's strengthening you rather than weakening you, you…

Garrett Soames: all I can say is I probably have a significant amount of scar tissue in my glutes but my squats stronger than it's ever been. Right. So That scar tissue is no longer concerned. For me. I would be concerned of if someone were Somehow it, missing and injecting attendant, that's a scar tissues and tendons, a different story but scar tissue in muscle Again, I still consider it micro trauma. It's not a huge needle. It's not like you're cutting in with a scalpel.

Brian Mckinley: Yeah, it's pretty small. Yeah.

Garrett Soames: It's a tiny little poke that Bleeds heels. and lays down issue and…

Brian Mckinley: vacuum in there as well as it spreads out. So there is some of that to I would assume.

Garrett Soames: Right, right. So I guess my two cents on the whole matter is, yeah, you're gonna get scar tissue, if you're gonna work, repeatedly, cause micro traumas with, injections in the same area. But That's never really been an issue as far as causing problems.

Brian Mckinley: I kind of lines up with my experience. I haven't been doing it as long but if anyone out there has other experience where they've been on medications from actual pharmacies and maybe they want to share Any type of scar tissue build up or personal experiences, Leave those down below. Maybe we'll make Another video at some point in talk about some of those and maybe get into them. So please share your experiences, but

Brian Mckinley: this is kind of a subjective matter because not a lot of studies on this specifically, but it seems like at least for us Scar tissue and muscles Maybe not as big of a concern as we used to think. Yeah.

Garrett Soames: I guess I'll just mention to if that's a concern for anyone, we know now and there's plenty of studies to prove that subcutaneous injections of TRT are entirely safe. the testosterone levels are equivalent to or sometimes, perhaps even slightly higher than I am injections.

Garrett Soames: Again, they seem to work just as well as intramuscular injection. So if provided, you feel fine doing subcutaneous injections, there's no reason you can't choose that over intramuscular, not at all. and I've done both, I am and sub-q. I've found both seem to work equally as well as far as how I feel and the positive effects.

Garrett Soames: so I think as long as you're just using sterile technique, either way, you'll be fine but if scar tissues are concerningers Just pinch some fat and inject it there and there's no reason to think that you can't, do that to, alternate it up or If you are concerned you're getting sore, in the muscles from injection, you can alternate from I am to suck. the dose the dose things the same.

Brian Mckinley: Yeah, that's true. That's true.

Garrett Soames: so, Yeah, the absorption rate in fat is slightly slower. Because there's less blood flow and subcutaneous fat. But what we've found is it creates a depot of that oil so because it's a slower release. If you do repeat sub Q injections technically, You get a much slower rise but also a slower fall. so again, for those who choose to exclusively, use subcutaneous, you are, like we talked about, the waves of highs and lows after injections Subcutaneous basically is a much smoother ride.

Garrett Soames: So, again as long as you Have no problems. sometimes feeling a small little lump where the oils there. that will obviously go down as the body, absorbs it, but it may be the better option for you, So,

Brian Mckinley: Yeah, so I mean there you go. I think you have alternatives. If you're worried about this, if you're someone who's been doing steroids or a TRT for a long time, our opinion are a true opinion not medical opinion. Is that, not that bad. Maybe even beneficial.

Brian Mckinley: Something to kind of be expected and it's a little bit different for muscles than other parts of your body and if you are worried about it sub-q is perfect alternative. if more science comes out we can change our opinion on that but it's kind of what we've seen through an adult evidence presented to us. But thank you for joining us today and we'll be back soon. Thank you very much.

Long-term TRT, Testosterone Injections, & Muscle Strength Benefits

In this excerpt from our podcast, we discuss the hidden danger of low testosterone when young. Low testosterone can lead to weight gain, energy loss, being unable to gain weight, and many other health problems. We look at recent studies around steroid use in younger age groups as well as our personal experiences to talk about the subject.






Brian Mckinley: like personal trainers. And significant amounts of money. You know TRT is definitely going to help you with body dysmorphia because most likely a lot of your problems are caused by being fat. Which is just a factual statement for people living in the United States. You are very likely to be fat at some point in your life TRT do it.

Garrett Soames:  Well, that's that. You have a 75% chance of being fat that's literally Yeah.

Brian Mckinley:  There you go, specifically very high chance of being fat and if your body does morphia is based on external stressors and symptoms, rather than like a mental health disorder and where it becomes one because of that, you know, being on TRT, does help with that. But like a big part of it is the whole Is the pressure of society?

Garrett Soames: Oh, well, you know, you bring up, you know, pressure and how like people are feeling this. This need to get ahead and is they actually did a recent study on steroid use in high schoolers, right? So,…

Garrett Soames: so it, um, in the past, like, in the, when they first did, the study was in the 90s on average, one in 64, male high schoolers. Just on average used has tried or used steroids one in 60,…

Brian Mckinley: You think about your graduating class of thousands that's not rare?

Garrett Soames:  Yeah, yeah that's a huge amount but is still enough, you know? And and then in the 2000s it almost doubled. So it's about one in about 30 now. Yeah.

Brian Mckinley: Really. I wouldn't have thought that I would have thought it went down with all the regulations and…

Garrett Soames: So there are more and now currently today. One twelve percent of male high schoolers have used steroids 12% of male high schoolers in the United States of America have used or experimented with steroids 12% more than 10.

Brian Mckinley: you know, I mean, To be fair to be fair. There's a lot of that pressure but also men in General's testosterone is going down. So like To reach higher standards than…

Brian Mckinley: what they were supposed to have reached before these new higher levels of standard like that you need to breach while still having lower levels. I don't think it's that surprising That so many people are just steroid use.

Garrett Soames: No. No. I mean, again, I've been doing medicine for a while and you know, normally you wouldn't test it a high schooler for low testosterone. Why would you they're young? You'd think this is the prime of their life.

Garrett Soames: But guess what? There are high schools with hypogonadism,…

Garrett Soames: you know, I mean when you've got six year olds who now officially like have obesity and they basically start at six with obesity and then by the time they make it till they're 18, they've had 12 years of being morbidly obese. You can imagine.

Garrett Soames: Yes. It's very likely that these kids have hypotheism

Brian Mckinley: And and that's the trouble too because like that for me that was the age of which, what I was, I was really overweight too and…

Brian Mckinley: that the trouble with that is like that impacts you while you're growing. You know, that's when you're growing, that's when you actually need your levels higher to get like the body you want later in life. So like, you know, maybe it's not that wild, but it's still just kind of crazy. That there's so much pressure…

Brian Mckinley: if there wasn't a pressure, no one would be doing it, right?

Garrett Soames: Right, right. No, that's like that. And that's kind of the point of what I brought it up is if It, you know, sure there are kids more kids are getting, you know, medical issues and hypogonadism. But I think the reason that that number has exponentially gone up is because more of the social pressures is now…

Garrett Soames: because every good movie that's out, there is a Marvel movie with Thor and Captain America and guys with six packs, and they just amazingly fit and good looking. There and…

Garrett Soames: again even the James Bond, like we brought up before is now six pack fit with like yoked arms and…

Brian Mckinley: Yeah, that's the standard.

Garrett Soames: does you know he's not here's prosper anymore,…

Garrett Soames: Is the standard. So now one in 10 more than one in ten male. You know, high schoolers are now using steroids in an attempt to reach that new standard. And so again, I think again we're really this whole body dysmorphia for men has changed significantly and…

Garrett Soames: and in fact, Yeah, there's this new term called bigorexia. And it's it's this. Yeah. It's it's just guys who feel like, they're too small. I'm too skinny. I'm too small. I need to get bigger. I need to get bigger. I need to get bigger, right? So they use more and more steroids or they use you…

Garrett Soames: and I'll admit I had bigger Xia because I was I was the opposite. Brian. I I was extremely skinny like I was on the wrestling team so I know exactly how much I would. I was in in sophomore year.

Garrett Soames: You know, I was almost six feet tall at that point. I was 98 pounds. So you know like yeah I was super I was rich.

Garrett Soames: You could receive my ribs. You know. Like I was skinny right? And so I did I ate so much I was eating like four or…

Garrett Soames: five thousand calories a day just to desperately try to get bigger and you know and even when you know puberty started hit and I was getting bigger and I was doing better and whatever. I was still I could never be more. I could never be muscular enough. I could never be big.

Garrett Soames: again that I probably went through all of my 20s and even into some of my 30s with that, that type of body work it.

Garrett Soames: Yeah, I I couldn't be more muscular and then You know, I actually reached this point where I was like 245 pounds, it's just yoked and enormously big.

Garrett Soames: Um, and I was in college, but all this eating to try to, you know, maintain all that I can't. I got a fever and I started taking some, Yeah, I had my, my wisdom teeth removed. I got a fever, I took a bunch of ibuprofen and that on top of all, I was trying to eat to, you know, get bigger. I basically burned a hole like straight through my stomach and, like, seriously and…

Garrett Soames: ultimately, I nearly died. Actually, my I got so anemic I was bleeding into in internally bleeding.

Garrett Soames: I I lost in like in like a month, I lost like 55 pounds of, you know. And yeah.

Garrett Soames: It was almost because I was all muscle. Then so and,…

Garrett Soames: you know, it was it took essentially Nearly dying for me to realize.

Brian Mckinley: You just you couldn't really fight the pressures and…

Garrett Soames: This is not a healthy thing. You know, and

Brian Mckinley: it's like it's not until your body starts to give out that. You like you hit the limit and the breaking point and you hit the realization point of like That s*** is unreal. How do people do that? And not everyone ever gets to hit that point and all I do is they chase a dream that doesn't exist their whole life and just sits with them. So, Like Yeah, I mean body dysmorphia is a real thing. I think it's a bigger thing than ever and there's like two things that men can do, which is like to get collectively. We need to, we need to have that body of positivity movement and we need to start like It's hard because of that, you know, everyone's hyper-masculine. Now, to kind of make up for things and it's hard to kind of want to support another guy, but like, we really need that

Brian Mckinley:  Positivity movement that women have started to get and you know beyond that. We don't want to let that toxic masculinity. Stop us from seeking. You know, hypergonadal testosterone related care, because like, I don't need anything else, I will get, probably do you live in America and you've been fat? For 16 17 years, you probably need testosterone. You're probably low. And so like, I don't know, you need to, we need that positive vibes and we need like To accept that maybe our testosterone levels are low and we should probably get them checked.

Garrett Soames: Yeah, absolutely. Yeah. So I again I think ultimately you know, we talked about mental health before and stuff. Ultimately I think the best thing you do for your mental health is to feel good with…

Garrett Soames: who you, right? And well. And that takes a lot of self-reflection and whatever, but you also have to feel good physically. So if you are suffering from symptoms of going out ism, you're never gonna be there. You're never gonna get there because no matter how positive you feel about yourself, you have to actually feel good too, right? So yeah,…

Brian Mckinley:  Yeah, you do you have to be able to be alive?

Garrett Soames: Right. and so again, I think if you, if you can treat, you know, yourself and you feel better on something like TRT, then you're you're only going to,…

Garrett Soames: you know, benefit as far as how you feel about how you look and, and again, about how you how comfortable you are in your own skin, So, you know, I don't know. Ultimately, again I think there's there's just a lot of societal pressures these days, you know, Instagram filters and…

Garrett Soames: all this crap, you know, and and it's not realistic. And in reality, I actually feel sorry for people, you know, who are younger because they're growing up with social media and they don't know any different and Yeah.

Brian Mckinley: Really, it's terrible. Honestly. I mean I'm pressure enough by it and I'm an adult at all. Like, Yeah,…

Brian Mckinley: I don't know. It's something that needs to change. I think for men or we just need to have some type of movement like that sometime soon where like, We want to accept men, not only for if they're funny. or if they're rich but also if they're just a person who's fat And not feel pressured to do a. Lot of crazy things like Yeah you want to get healthy for helping us a sake but like Don't give body this more feel over it because the goal is set astronomically far from what's possible. You know, I think that's the goal adjustment, is what we need there. But yeah,…

Brian Mckinley: thank you guys for joining us. Today, we're gonna wrap up And we'll catch you guys next time. Thanks for. Thanks for watching.

Garrett Soames:  All right. See you next time.

Under or Overweight, the Hidden Danger of Low T (Podcast Excerpt)

Testosterone Replacement Therapy (TRT) is a medical treatment designed to restore testosterone levels in men experiencing low testosterone (low T). If you're new to TRT, understanding key terms, dosing schedules, and ancillary medications is essential to optimizing your treatment. This guide covers the basics of TRT, helping you navigate your journey with confidence.

: A medical treatment for men with clinically low testosterone levels, typically involving the administration of exogenous (external) testosterone.

: A class of drugs that reduces estrogen levels by inhibiting the aromatase enzyme, which converts testosterone into estrogen.

: A hormone that mimics luteinizing hormone (LH), stimulating the testes to produce testosterone and maintain fertility during TRT.

: The highest level of testosterone in the bloodstream, occurring shortly after an injection.

: The lowest level of testosterone in the bloodstream, typically occurring just before the next scheduled dose.

: A hormone derived from testosterone; while necessary in small amounts, excessive estrogen can cause side effects like water retention and gynecomastia (breast tissue growth in men).

: The biologically active form of testosterone that is not bound to proteins in the blood and is available for use by the body.

Typical TRT Dosing Schedules & Their Rationale

One of the most common questions about TRT is how often injections should be administered. The goal of dosing schedules is to maintain stable testosterone levels while minimizing side effects. Below are the common injection frequencies and their reasoning:

Large peaks and troughs can lead to fluctuations in mood, energy, and libido

Higher likelihood of estrogen conversion due to higher peak levels

100–200 mg of testosterone cypionate or enanthate per week

More stable testosterone levels, reducing peaks and troughs

Lower estrogen conversion compared to once-weekly dosing

Reduced risk of side effects like mood swings and fatigue

50–100 mg of testosterone cypionate or enanthate every 3.5 days

Provides the most stable testosterone levels

Minimizes peaks and troughs almost entirely

Subcutaneous injections are easier and less painful than intramuscular injections

10–20 mg of testosterone cypionate or enanthate per day

In some cases, additional medications may be used alongside testosterone to optimize results and manage side effects. Here are some of the most common ancillary medications:

Used to stimulate the testes to continue producing testosterone and sperm, helping maintain fertility and preventing testicular atrophy.

Common dosing: 250–500 IU 2-3 times per week

Aromatase Inhibitors (AIs) (e.g., Anastrozole, Letrozole, Exemestane)

Used to control estrogen levels in men who experience excessive conversion of testosterone to estrogen.

Overuse can lead to dangerously low estrogen, which may cause joint pain, mood swings, and cardiovascular issues.

Common dosing: 0.25–0.5 mg of Anastrozole once or twice per week (only when necessary)

Sometimes prescribed as an adjunct to TRT to help with joint pain and muscle growth.

Can suppress natural testosterone production if not properly managed.

Common dosing: 50–150 mg per week, usually in combination with TRT.

A mild anabolic steroid sometimes used in conjunction with TRT to improve body composition and strength.

Can impact liver function and lipid profiles, so monitoring is necessary.

Common dosing: 10–25 mg per day in short cycles.

TRT is designed to restore healthy testosterone levels in men with low T, improving energy, mood, libido, and overall well-being.

Dosing schedules vary, with more frequent injections leading to more stable hormone levels and fewer side effects.

Ancillary medications like hCG and AIs can be useful but should be used only when necessary and under medical supervision.

Regular bloodwork is essential to monitor testosterone, estrogen, and other markers to ensure optimal results and minimize risks.

If you're considering TRT, consult with a knowledgeable provider to determine the best protocol for your specific needs. A well-managed TRT regimen can lead to significant improvements in quality of life when approached correctly. At 

, we are committed to providing the best resources and medical expertise to support you in your TRT journey. Visit 

 to learn more and take the first step toward optimizing your health.

Testosterone Replacement Therapy (TRT) 101: A Beginner's Guide

Exploring the journey of Testosterone Replacement Therapy (TRT) at AlphaMD.org, we often address questions about 'TRT before and after'. This post delves into the typical experience, highlighting the contrast between pre-treatment symptoms of low testosterone and the post-treatment benefits.

The Low Testosterone Scenario: Before TRT

Low testosterone can manifest through various physical, mental, and sexual health challenges:

Increased body fat, especially around the abdomen

Reduced bone density, posing risks for osteoporosis


Concentration difficulties and memory lapses

Mood fluctuations and increased irritability

Erectile dysfunction or compromised sexual function

Post-TRT, patients typically report significant improvements across various aspects of their health and well-being:

Elevated energy levels and improved physical performance

Improved bone density and reduced risk of fractures

Sharper focus and improved cognitive functions

Heightened sense of well-being and confidence

Improved erectile function and overall sexual health

Potential improvements in sperm production

TRT can also offer several other health benefits, which include:

 Some studies suggest that effective TRT can positively influence heart health by improving cholesterol profiles and endothelial function.

 TRT has been linked to better regulation of blood sugar levels, which is particularly beneficial for patients with metabolic syndrome or type 2 diabetes.

 Overall improvements in mood, energy, and physical health contribute to enhanced quality of life.

TRT should be approached as a personalized treatment plan under medical supervision. At AlphaMD.org, we ensure that TRT is safely administered, tailoring the therapy to individual needs and continuously monitoring progress.

The 'TRT before and after' narrative is one of transformation and rejuvenation. If you're experiencing symptoms related to low testosterone, TRT might be a viable solution to not just alleviate those symptoms but also significantly enhance your quality of life.

Ready to learn more about TRT and its potential benefits? Make an appointment today for expert guidance and to start your journey toward a healthier, more vibrant life.

TRT Before and After: Anticipating the Benefits and Changes

At AlphaMD.org, we understand that personalized treatment is key in testosterone replacement therapy (TRT). A common question from our patients is about the impact of different injection methods, particularly regarding intramuscular vs. subcutaneous injections. In this post, we'll explore both methods, including instances where SubQ injections are recommended.

Testosterone injections are generally administered in two ways: intramuscularly (into the muscle) and subcutaneously (under the skin). The choice between these methods depends on various factors, including the dosage, patient comfort, and absorption rates.

Intramuscular injections involve delivering testosterone deep into the muscle, typically in the thigh or buttock. This method is traditionally preferred for its efficient absorption into the bloodstream and is often used for higher dosages.

SubQ injections, where testosterone is injected into the fatty layer under the skin, are gaining acceptance, especially for lower dosages. This method can be less painful and is suitable for patients who prefer a more straightforward, self-administered approach.

 Intramuscular injections may offer quicker absorption, while SubQ injections provide a more consistent release of testosterone over time.

 Many patients find SubQ injections to be less painful and easier to self-administer.

 For lower dosages of testosterone, SubQ injections are often recommended due to their effectiveness and reduced discomfort.

Regardless of the method, it's essential to follow best practices for testosterone injections:

 Learn the correct technique for your chosen method to minimize complications.

 Work with a healthcare provider at AlphaMD.org to determine the best method and dosage for your needs.

 Regular monitoring of testosterone levels and overall health is crucial, regardless of the injection method.

Intramuscular and subcutaneous testosterone injections both have their place in TRT. At AlphaMD.org, we recommend the best approach based on individual patient needs, preferences, and medical history. Understanding the differences can help you make an informed decision about your treatment.

If you have questions about testosterone injection methods or want to know which approach is right for you, contact us at AlphaMD.org. Our team is here to provide personalized care for your TRT journey.

Understanding Testosterone Injection Methods: Intramuscular vs. Subcutaneous

How does Telemedicine compliance current work with the live rules, laws, and regulations evolving in healthcare today?


Both the DEA and HHS extended telemedicine flexibilities for prescription of controlled substances until December 31, 2024 as of their statement released on September 29.  

https://www.federalregister.gov/documents/2023/10/10/2023-22406/second-temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled

"In light of the need to further evaluate the best course of action given the comments received in response to the NPRMs and the presentations at the Telemedicine Listening Sessions, DEA, jointly with HHS, is issuing this second temporary rule (“Second Temporary Rule”) extending the full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID–19 PHE, through December 31, 2024. This extension authorizes all DEA-registered practitioners to prescribe schedule II–V controlled medications via telemedicine through December 31, 2024, whether or not the patient and practitioner established a telemedicine relationship on or before November 11, 2023. In other words, the grace period provided in the First Temporary Rule is effectively subsumed by this Second Temporary Rule, which continues the extension of the current flexibilities for all practitioner-patient relationships—not just those established on or before November 11, 2023—until the end of 2024.

The purpose of this Second Temporary Rule, like the one before it, is to ensure a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions, as well as allowing adequate time for providers to come into compliance with any new standards or safeguards. DEA is working to promulgate new standards or safeguards by the fall of 2024."

This extension authorizes all DEA-registered practitioners to prescribe schedule II–V controlled medications via telemedicine through December 31, 2024, whether or not the patient and practitioner established a telemedicine relationship on or before November 11, 2023. In other words, the grace period provided in the First Temporary Rule is effectively subsumed by this Second Temporary Rule, which continues the extension of the current flexibilities for all practitioner-patient relationships—not just those established on or before November 11, 2023—until the end of 2024.

Even as of January 1, 2025 if the old rules go into effect, so long as the patient was referred to us by their PCP, it is still perfectly acceptable to prescribe controlled substances to patients without a physical exam.

https://www.dea.gov/press-releases/2023/02/24/dea-announces-proposed-rules-permanent-telemedicine-flexibilities

"The proposed rules also would not affect:
Telemedicine consultations and prescriptions by a medical practitioner to whom a patient has been referred, as long as the referring medical practitioner has previously conducted an in-person medical examination of the patient."

DEA Telemedicine Compliance

Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old

There is an age-related decline in male testosterone production. It is therefore surprising that young men are evaluated for testosterone deficiency with the same cutoff of 300 ng/dL that was developed from samples of older men. Our aim is to describe normative total testosterone levels and age-specific cutoffs for low testosterone levels in men 20 to 44 years old.

We analyzed the 2011-2016 National Health and Nutrition Examination Surveys, which survey nationally representative samples of United States residents. Men 20 to 44 years old with testosterone levels were included. Men on hormonal medications, with a history of testicular cancer or orchiectomy, and with afternoon/evening laboratory values were excluded. We separated men into 5-year intervals and evaluated the testosterone levels of each age group, and for all men 20 to 44 years old. We used the American Urological Association definition of a "normal testosterone level" (the "middle tertile") to calculate age-specific cutoffs for low testosterone levels.

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