What happens first: the symptom history?
The visit opens with you, not the numbers. Your provider asks what changed, when, and how much it bothers you: libido, morning erections, energy, strength, mood, sleep, focus and weight. Expect questions about training, alcohol, pain medicines and steroids, and about whether you hope to have children.
The conversation replaces a checklist on purpose. The AUA guideline does not recommend using validated questionnaires to decide who is a candidate for testosterone, so your own description, ideally backed by a few weeks of notes, carries the weight. Our guide to tracking symptoms before a consult shows a simple format.
How is each lab result reviewed?
One line at a time, with you looking at the same page. The TRT pre-screening panel covers four markers, and your provider may add others.
| Result | What your provider checks |
|---|---|
| Total testosterone | Whether it is below the AUA’s 300 ng/dL cutoff, and whether a second morning test agrees |
| Estradiol | A baseline for later, and a closer look if you have breast symptoms |
| PSA | Prostate safety before treatment, which the AUA asks for in men over 40 |
| Hematocrit (in the blood count) | Whether red cells are already high before testosterone pushes them up |
| LH, if added | Whether the testes or the pituitary signal is the weak link |
| Prolactin, if added | Recommended by the AUA when LH is low or low-normal |
| Free testosterone and SHBG, if added | Useful when the total is borderline |
Some results stop the conversation for now. The Endocrine Society advises against starting testosterone with a PSA above 4 ng/mL, or above 3 in men at high risk, without a urology evaluation, and lists an elevated hematocrit as a reason not to start. Our page on the TRT pre-screening panel explains each marker in more depth.
How are the form and dose decided?
By matching the options to your labs and your life. Ultimate Male offers injectable testosterone, oral Kyzatrex capsules, Pellecome pellets and HCG (Pregnyl), and each fits a different man.
Fertility plans come first in that choice, since the AUA advises against testosterone for men trying to conceive. Blood pressure comes next: the FDA’s 2025 labeling changes added blood pressure warnings across testosterone products. After that, routine, comfort with injections and how often you want to come in shape the decision.
Your provider sets the starting dose. The AUA’s aim is a total testosterone in the middle third of the normal range, about 450 to 600 ng/dL, and the dose is adjusted toward that over the first months. Our answer on the TRT starting dose explains how that first number is chosen.
What follow-up schedule do you agree before leaving?
You should walk out knowing your next lab date. The schedule depends on the form chosen:
- Kyzatrex: the Kyzatrex label calls for a testosterone level 7 days after starting, and hemoglobin or hematocrit about every 3 months.
- Injections and pellets: a first recheck once levels settle, then testosterone and hematocrit every 6 to 12 months under the AUA guideline.
- Prostate: the Endocrine Society recommends reassessing prostate risk 3 to 12 months after starting.
The written plan you leave with lists the medicine, the dose, the schedule, the side effects to watch and those dates. Our answer on how many visits TRT takes in the first year puts the whole calendar together.
Related question: what if my results do not support TRT?
Then the consultation turns to why you feel the way you do. That might mean a repeat morning test, a look at sleep, thyroid or medicines, or a different treatment altogether. Our answer on what happens when labs show no TRT is needed covers the usual next steps.
Preparing for your consultation at Ultimate Male
At San Gabriel or Downey, the consultation is one-on-one with Matthew A. Schafer, PA-C, or David A. Nyberg, MD, and your TRT pre-screening panel is bundled with it. Bring your symptom notes, your medicine list, any outside labs and your questions; our list of questions to ask at a men’s health consultation is a good starting point.
Our step-by-step guide to the first TRT visit covers the days before and after. When your labs are booked, schedule the consultation for a day or two after the draw, and come ready to decide whether testosterone therapy is right for you.
