Testosterone Replacement Therapy (TRT) in Las Vegas

Testosterone replacement therapy (TRT) is the medically supervised use of testosterone for men with clinically low levels confirmed by bloodwork and consistent symptoms - fatigue, low libido, loss of muscle mass, low mood, brain fog. TRT is one form of hormone replacement therapy (HRT); the same evaluation-first approach covers the broader hormone picture. Those symptoms have many possible causes, and low testosterone is only one of them. That is why care here starts with a hormone panel and a physician's evaluation, not a prescription pad.

At LiveNow Longevity, board-certified neurologist Dr. Charles Kamen, MD reviews your labs, history, and clinical picture first, and prescribes TRT only when both support it. Sometimes the answer is no - and when it is, you hear it at the $88 evaluation, along with what to investigate instead. When TRT is prescribed, dosing is individualized, follow-up labs are scheduled at intervals, and medication comes from a licensed US pharmacy at pass-through cost with no markup. See our cost and pricing guide and our broader hormone optimization program for details.

We serve Las Vegas, Henderson, Green Valley, and all of Nevada - in person at our clinic at Eastern Avenue and the 215, or by secure telehealth.

None of the available times work? Text us or call (702) 808-2650 and we’ll sort it out.

Major guidelines agree on the core of a testosterone workup. Low testosterone is confirmed with two separate early-morning, fasting total testosterone tests, because levels swing through the day and one low reading is not a diagnosis. The American Urological Association uses 300 ng/dL as a reasonable cut-off, and symptoms have to fit too.

• Total testosterone, measured twice in the morning while fasting
• Free testosterone, directly measured or calculated, when binding proteins may skew the total
• LH and FSH, which show whether the problem starts in the testes or in the pituitary
• A blood count for hematocrit, since testosterone raises red blood cell levels
• PSA for men who fit prostate cancer screening, discussed before treatment starts

Dr. Kamen sets the exact panel at the evaluation based on your history and medications.

TRT is not set and forget. Testosterone levels are rechecked early to confirm the dose lands in range. The timing depends on the form, for example a few weeks after starting a gel or after a few cycles of injections. Hematocrit is followed during treatment. A hematocrit of 54% or higher calls for a dose change, and a baseline above 50% means holding off until the cause is found. PSA is followed in men who are being screened for prostate cancer. After the first months, labs move to a longer interval if everything is stable.

Testosterone products can increase blood pressure. FDA's February 2025 labeling action requires blood-pressure warnings across testosterone products. Removing the boxed-warning language about increased adverse cardiovascular outcomes after TRAVERSE did not remove this blood-pressure warning. Blood pressure is a separate safety consideration to discuss with the prescribing clinician.

The Endocrine Society advises against starting testosterone in men who:

• Plan to father a child in the near term
• Have breast or prostate cancer, or a prostate nodule or elevated PSA that has not been checked by a urologist
• Already have a high hematocrit
• Have untreated severe obstructive sleep apnea or severe urinary symptoms
• Have uncontrolled heart failure, a clotting disorder, or a heart attack or stroke in the last 6 months

Testosterone from outside the body tells the brain to stop signaling the testes. Sperm production drops, sometimes to zero. It often recovers after stopping, but that can take months and is not guaranteed. Men who want children soon should say so at the first visit. Other approaches exist, and a referral to a urologist or fertility specialist may be the right call.

Many men come in for fatigue, low mood or brain fog. The clinical trials give a more mixed picture. In the Testosterone Trials, older men with low testosterone saw modest gains in sexual function and some improvement in mood and depressive symptoms, but no gain in vitality (Snyder, NEJM 2016). The companion cognitive trial found no improvement in memory or other thinking skills (Resnick, JAMA 2017).

On safety, the TRAVERSE trial found testosterone did not raise the rate of major heart events in men with low testosterone and heart risk. It did see more atrial fibrillation, acute kidney injury and pulmonary embolism (Lincoff, NEJM 2023). As a neurologist, Dr. Kamen also looks for the common causes of fatigue and fog that testosterone will not fix: sleep apnea, thyroid disease, depression, medication effects and low iron or B12.

Sources

1. Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018.
2. Mulhall JP, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018.
3. Snyder PJ, et al. Effects of Testosterone Treatment in Older Men. N Engl J Med. 2016.
4. Resnick SM, et al. Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment. JAMA. 2017.
5. Lincoff AM, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023.
6. FDA. Class-wide labeling changes for testosterone products: blood-pressure warnings and TRAVERSE findings. February 28, 2025.