What to Expect at Your First TRT Appointment

Introduction

Taking the first step toward testosterone replacement therapy can feel intimidating. Men often hear conflicting advice from blogs, gyms or friends and wonder whether hormone therapy is right for them. At Total Health Pros in Hurricane, West Virginia, we aim to demystify the process. Our clinic combines over 20 years of experience in functional medicine, bioidentical hormones, nutrition, and body composition analysis. This article walks you through exactly what to expect at your first TRT appointment—no surprises, just facts.

Why evaluate testosterone?

Testosterone is the hormone that drives masculine characteristics such as muscle mass, bone density, body hair and sex drive. Levels increase sharply during puberty, stabilise in early adulthood and then slowly decline by about 1 % per year. When testosterone drops too quickly or too far, men may develop fatigue, low mood, reduced libido or decreased muscle mass. Healthcare providers diagnose this condition as male hypogonadism. Before starting therapy, we need to confirm a true deficiency and identify any underlying causes such as pituitary or testicular problems.

Preparing for your appointment

Your first visit begins before you walk through the door. A few days ahead of time, make a list of symptoms and when they began. Include stressors, major life events, childhood illnesses or surgeries, medications and supplements. Bring your questions: What caused my symptoms? What tests do I need? Is this condition temporary or chronic?. If possible, schedule the appointment in the morning; testosterone levels fluctuate throughout the day and peak before 10 a.m., so early blood draws provide the most accurate results.

Health history and physical exam

During the consultation, a clinician—often Dr. Darrin A. VanScoy or our nurse practitioner—will review your medical history, family history, lifestyle habits and sexual function. A focused physical exam assesses body composition, blood pressure, testicular size and prostate health. We discuss medications that might suppress testosterone, such as opioids or steroids, and conditions that could influence hormone levels like sleep apnea or obesity. At Total Health Pros we believe in functional medicine, so we also examine nutrition, gut health and stress levels.

Diagnostic testing

The most critical part of the first visit is laboratory evaluation. Cleveland Clinic notes that providers confirm low testosterone by ordering two morning testosterone tests. Because testosterone levels vary from day to day, two separate readings below the normal range (usually <300 ng/dL) confirm the diagnosis. Additional tests are equally important. Hemoglobin and hematocrit detect anemia or excessive red blood cell production; liver function tests ensure that your liver can metabolise testosterone safely; luteinising hormone (LH) reveals whether the pituitary gland is signalling the testes correctly; prostate‑specific antigen (PSA) and prolactin tests screen for prostate issues and pituitary tumours. At Total Health Pros, we may also check thyroid function, fasting glucose, lipid profile and vitamin D to get a complete picture of your metabolic health.

Many men worry that we will push them into treatment prematurely. Rest assured, we only recommend TRT when tests and symptoms align. If your testosterone is borderline low, lifestyle interventions—like weight loss, sleep optimisation and stress management—may be tried first. Our team will explain each lab result and what it means for your health.

Understanding the results and deciding if TRT is appropriate

Once test results return (typically within a few days), we meet again to review them. You’ll learn whether your testosterone is low and if other hormones such as LH, thyroid‑stimulating hormone (TSH) or cortisol suggest a primary testicular problem or a pituitary/hypothalamic issue. We also discuss whether your symptoms warrant therapy. TRT is generally reserved for men with both low testosterone levels and significant symptoms; it is not approved for aging‑related decline without a medical cause. Contraindications include untreated prostate cancer, high red blood cell count, recent heart attack or stroke, severe sleep apnea or a desire for fertility (TRT can reduce sperm production). If any of these apply, we discuss alternative approaches.

Your first TRT treatment

If we agree that TRT is appropriate, we present the available formulations. Options include daily gels applied to the skin, weekly or bi‑weekly self‑injections, long‑acting pellets inserted every three to six months, nasal gels and oral capsules. Each has pros and cons. Gels deliver steady hormone levels but require caution to avoid transferring medication to partners or children. Intramuscular injections provide higher peaks and troughs but are cost‑effective and can be self‑administered. Pellets offer convenience but require a minor surgical procedure. We’ll work together to choose the option that fits your lifestyle and insurance coverage.

At the first treatment visit, we demonstrate how to apply or inject testosterone. For injections, you’ll learn to draw up the medication and inject into the thigh or gluteal muscle. If you prefer not to self‑inject, our clinic staff can perform injections for you. Gel users will see where to apply the medication and how long to wait before showering or swimming.

Monitoring and follow‑up

Starting TRT is not a one‑and‑done event. Because testosterone therapy can increase red blood cell count and affect the prostate and liver, regular follow‑up is critical. Cleveland Clinic emphasises that after initiating TRT, patients need ongoing blood work and monitoring to ensure the therapy is safe. During the first year we schedule check‑ups every three to six months, repeating testosterone levels, hemoglobin, hematocrit, PSA and liver enzymes. We also assess your symptoms—energy, libido, mood, strength—and adjust dosage accordingly. If side effects occur (acne, fluid retention, breast enlargement, sleep apnea or elevated PSA), we reduce the dose or consider alternative treatments.

Why Total Health Pros?

Many clinics simply prescribe testosterone and leave you on autopilot. At Total Health Pros, we treat hormone imbalances as part of a whole‑body approach. Dr. VanScoy is a chiropractic physician, certified functional medicine specialist and professional bodybuilder. Our team offers Styku 3D body scanning to measure visceral fat and muscle mass, FoodAlign testing to identify food sensitivities, and nutrition coaching to help you maintain a healthy weight—a key factor in maintaining testosterone levels. We track your progress with a secure app that rewards healthy behaviours and offers membership plans for ongoing support. Because we are based in Hurricane, WV, you don’t need to travel far; our local focus fosters a supportive community.

Conclusion

Your first TRT appointment is an opportunity to take control of your health. By preparing properly, understanding the diagnostic tests and choosing a therapy plan that fits your goals, you can restore energy, build muscle and improve your overall well‑being. If you live in Hurricane, WV or the surrounding region and suspect low testosterone, contact Total Health Pros at 206 Chase Park. Our team of experts will guide you every step of the way.