How We Evaluate Care
Our Clinical Standards
Most TRT providers tell you to trust them. We would rather show you exactly what we hold our partner providers to — and let you decide whether that meets the standard you expect.
What Makes a Genuine Candidate
Responsible TRT evaluation requires two things: symptoms that are consistent with low testosterone, and lab results that support that picture. Either one alone is not enough.
Symptoms — fatigue, reduced libido, difficulty maintaining muscle, brain fog, mood changes, poor sleep — overlap significantly with other conditions. Stress, poor sleep, excess body weight, thyroid dysfunction, and nutritional deficiencies can each produce an identical symptom profile. A physician who does not account for this is not doing a full evaluation.
Lab results similarly require context. A total testosterone reading taken at the wrong time of day, during a period of illness, or after significant sleep deprivation can produce a misleading number. The result and the clinical picture need to align.
What Labs Are Evaluated
A complete testosterone panel is standard. This includes total testosterone, free testosterone, LH, FSH, and SHBG. These values together tell a more complete story than total testosterone alone — they help a physician understand whether suppression is coming from the testicular level, the pituitary level, or somewhere else.
Total testosterone below approximately 300 ng/dL combined with consistent symptoms is the commonly referenced clinical threshold. The exact number matters less than what it means in context. A man at 280 ng/dL with no symptoms is a different clinical picture from a man at 280 ng/dL who has been struggling for two years.
Additional baseline markers — haematocrit, PSA, comprehensive metabolic panel — are standard practice before initiating treatment. They establish a baseline for monitoring and flag any contraindications.
What Monitoring Looks Like
The prescription is not the end of the evaluation — it is the beginning of an ongoing clinical relationship. Responsible TRT involves follow-up labs to confirm therapeutic levels are being reached, to monitor haematocrit, and to adjust dosing as needed.
A provider who prescribes and disappears is not providing supervised care. Follow-up is not a formality. Testosterone levels that consistently run high, or that suppress LH/FSH in ways that affect fertility, require active management.
What Would Disqualify a Candidate
Not everyone who wants TRT is a good candidate for it. That is not a failure of the evaluation process — it is the point of it.
- —Testosterone levels that fall within or above the normal reference range, combined with symptoms that are likely explained by other factors
- —Active fertility plans — TRT suppresses natural testosterone production and significantly impairs sperm production
- —Elevated haematocrit or polycythaemia, which increases thrombosis risk
- —Certain cardiovascular conditions that require specialist evaluation before initiating therapy
- —Age and symptom profiles where the evidence for treatment benefit is weak or uncertain
What We Evaluate Our Partner Providers Against
Gladius Health is currently a marketing and information service that refers patients to partner providers for treatment. We are transparent about that. We earn a referral fee when a connection is made.
Before recommending any provider, we evaluate them against the standards described on this page: physician credentials and licensure, documented lab requirements before prescribing, follow-up and monitoring protocols, and clear prescribing thresholds. We do not refer to providers who approve treatment without adequate evaluation.
If our assessment of a partner ever changes, we will update our recommendation accordingly.
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A board-certified physician will review your results. If TRT is not the right call, the evaluation will say so.
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