At HFW Longevity, we evaluate testosterone, free testosterone, SHBG, thyroid, cortisol, insulin, inflammation, metabolism, and safety markers before building a physician-guided TRT plan when clinically appropriate.
Physician-Led
100% Telehealth
Nationwide
HSA/FSA Accepted
Trusted by 1000+ patients across USA
Jenny Pourakis
Stella Blanch Apo
It’s been a blessing working with Dr. Landi and his entire team! After getting my test results, Dr. Landi walked me through a number of helpful steps to restore my health. He is very knowledgeable and uses an in-depth functional medicine approach in addressing health concerns. Bernadette is also very kind and thoughtful and I enjoy the interpersonal connection I have built with all of them.
Chase Natale
Fatimah Fahmy
Lauren Griffith
Kevin Heckman
Testosterone affects more than libido.
Low testosterone may show up as:
Too many men are either dismissed or overprescribed.
Testosterone therapy should answer:
We do not just raise testosterone. We optimize the system around it.
| Typical HRT Care | HFW Longevity | |
|---|---|---|
What they look at |
Total testosterone and symptoms
|
Total T, free T, SHBG, LH/FSH, estradiol, thyroid, cortisol, insulin, inflammation, metabolism, safety markers, and body composition
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What you hear |
“Your T is low. Here’s testosterone.”
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“Let’s find out why it’s low and whether TRT is the right tool.”
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Testing |
Basic testosterone lab
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Comprehensive hormone and safety bloodwork, metabolic markers, thyroid, inflammation, and advanced testing when appropriate
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Treatment |
Generic injections or cream
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Personalized testosterone strategy with route, dose, monitoring, and adjustments
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Support |
Minimal follow-up
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Quarterly labs, symptom review, biomarker tracking, and protocol adjustment
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Goal |
Increase the number
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Improve energy, libido, mood, recovery, strength, body composition, and long-term health
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Access |
Office visits or quick online prescription
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100% telehealth with local labs, at-home testing options, and pharmacy coordination
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When testosterone deficiency is confirmed and therapy is appropriate.
| Area | Why It Matters |
|---|---|
|
Libido + Sexual Function
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Testosterone can influence sex drive, erectile function, confidence, and sexual vitality.
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Energy + Drive
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Low testosterone may contribute to reduced motivation, low stamina, and diminished performance.
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Muscle + Strength
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Testosterone influences lean mass, strength, training response, and recovery capacity.
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Body Composition
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Testosterone interacts with insulin, cortisol, thyroid, inflammation, and lifestyle to affect fat and muscle balance.
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Mood + Resilience
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Low testosterone may overlap with irritability, low mood, reduced confidence, and stress intolerance.
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Bone Health
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Testosterone plays a role in bone density and long-term skeletal health.
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Metabolic Health
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Testosterone does not work alone. Blood sugar, insulin, weight, sleep, inflammation, and nutrition all shape outcomes.
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Good testosterone care includes knowing when not to prescribe.
Before TRT is considered, HFW reviews:
The goal is not to put every man on testosterone.
The goal is to identify who actually needs it, who can use it safely, and what should be fixed first.
We test before we treat.
| Test | What It Can Reveal |
|---|---|
|
Total Testosterone x2
|
Helps confirm whether testosterone is consistently low, ideally measured in the morning on separate occasions.
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Free Testosterone
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Shows how much testosterone is biologically available.
|
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SHBG
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Helps explain why total testosterone may not match symptoms.
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LH + FSH
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Helps distinguish primary testicular patterns from pituitary or signaling-related patterns.
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Estradiol
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Helps track estrogen conversion, mood, libido, water retention, and breast-related symptoms.
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CBC + Hematocrit
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Tracks red blood cell changes and polycythemia risk during therapy.
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PSA When Appropriate
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Used as part of prostate safety review, especially in men over 40.
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CMP
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Reviews liver, kidney, electrolytes, and general safety markers.
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Glucose + Insulin + HbA1c
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Reveals metabolic patterns that may affect testosterone and body composition.
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Lipids + Cardiovascular Markers
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Helps assess long-term risk and monitor changes during care.
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Full Thyroid Panel
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Evaluates thyroid-related fatigue, weight resistance, low mood, and metabolic slowdown.
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Cortisol / Adrenal Testing
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Helps explain stress-driven fatigue, poor sleep, belly fat, cravings, and low resilience.
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Inflammatory Markers
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Shows whether inflammation may be affecting hormones, metabolism, pain, or recovery.
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DEXA / Body Composition When Appropriate
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Tracks lean mass, visceral fat, fat mass, and bone health.
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Built around your numbers, symptoms, safety markers, and goals.
1
A physician-guided injectable testosterone option may be considered when clinically appropriate, with dosing, frequency, monitoring, and adjustments based on symptoms and labs.
2
A topical testosterone option may be considered for patients who prefer a non-injectable route or where the provider determines it is a better clinical fit.
3
Metabolic Optimization
Blood sugar, insulin, belly fat, inflammation, sleep, and body composition can all affect testosterone. HFW addresses the system, not just the hormone.
4
Thyroid dysfunction and cortisol dysregulation can mimic or worsen low-testosterone symptoms like fatigue, weight gain, poor sleep, low mood, and low drive.
Estrogen is not “bad.” Men need appropriate estradiol for libido, mood, bone, and cardiovascular health. The issue is balance and symptoms.
Fertility-Aware Strategy
For men who want future fertility, HFW reviews alternatives, risks, timing, and whether TRT is appropriate at all.
Peptide or Bioregulator Support
When clinically appropriate, peptides or bioregulators may support recovery, body composition, mitochondrial function, inflammation regulation, tissue repair, or longevity.
Nutrition + Lifestyle Strategy
A realistic plan built around protein, resistance training, sleep, alcohol, blood sugar, inflammation, stress, and recovery.
Nothing random.
Nothing guessed.
Nothing copied from another patient.
We review your symptoms, goals, sleep, libido, fertility plans, and medical history, then talk through whether HFW is the right fit.
Testing and safety review look past a single testosterone number to map free T, SHBG, estradiol, thyroid, cortisol, and metabolism. Bloodwork ships to your door or gets coordinated locally.
Your provider reviews the data and decides whether TRT, metabolic correction, thyroid support, or lifestyle change makes sense, with clear reasoning.
We address why testosterone is low in the first place, treating the metabolic, thyroid, cortisol, and inflammation patterns around it, not just the hormone.
Your protocol begins with the right route and dose when appropriate, pharmacy coordination, nutrition strategy, and ongoing monitoring.
Quarterly labs, safety monitoring, and symptom reviews help you protect your progress and adjust dosing as your body responds.
| We Track | Why It Matters |
|---|---|
|
Total Testosterone
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Shows whether levels are moving into the intended clinical range.
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Free Testosterone
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Helps evaluate how much testosterone is available to tissues.
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SHBG
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Helps explain symptoms when total and free testosterone do not align.
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Estradiol
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Helps monitor conversion, libido, mood, water retention, and breast symptoms.
|
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LH + FSH
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Helps evaluate baseline cause and fertility-related considerations.
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CBC + Hematocrit
|
Helps monitor red blood cell elevation and polycythemia risk.
|
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PSA When Appropriate
|
Supports prostate safety monitoring.
|
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Lipids
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Tracks cardiovascular risk patterns.
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Glucose + Insulin
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Shows how metabolic health is changing.
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Liver + Kidney Markers
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Supports general safety monitoring.
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Blood Pressure
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Helps track cardiovascular response and overall risk.
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Sleep Quality
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Poor sleep and sleep apnea risk can affect testosterone and safety.
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Body Composition
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Tracks lean mass, fat mass, visceral fat, and strength-related progress.
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Symptoms
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Libido, erections, energy, mood, motivation, focus, recovery, sleep, and performance.
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You should not have to wonder whether your TRT plan is working.
You should be able to see it.
Physician-led care. Root-cause strategy. Long-term optimization
Christina Warner, APN, NP-C
Board-Certified Nurse Practitioner
25 years of clinical experience with a focus on hormones, gut health, chronic inflammation, womenu2019s health, and root-cause care.n
Dr. Eric Landi, KICP
Functional Medicine Doctor
Over a decade of clinical experience with advanced functional testing, peptide therapy, metabolic optimization, and data-driven longevity protocols.
Medical Director
Book a free virtual consultation to review your symptoms, health history, prior labs, goals, and whether TRT or a broader testosterone optimization plan makes sense for you.
TRT stands for testosterone replacement therapy.
It is used to support men with symptoms of testosterone deficiency and consistently low testosterone levels. At HFW, TRT is considered only after reviewing symptoms, labs, safety markers, fertility goals, and clinical fit.
You cannot confirm low testosterone from symptoms alone.
AUA guidance recommends diagnosing low testosterone only after two early-morning total testosterone measurements taken on separate days, and only when low levels are combined with symptoms or signs. (AUA Network)
Low testosterone may be associated with reduced libido, erectile changes, fatigue, reduced endurance, depressed mood, low motivation, poor concentration, impaired memory, irritability, infertility, reduced physical performance, and body composition changes. (AUA Network)
It may help in properly selected testosterone-deficient patients.
AUA guidance says testosterone therapy may improve erectile function and low sex drive in some patients, but results depend on root cause, vascular health, medications, sleep, stress, metabolic health, and relationship factors. (AUA Network)
Not always.
AUA guidance says evidence is inconclusive on whether testosterone therapy improves energy, fatigue, cognitive function, diabetes measures, lipid profiles, and overall quality-of-life measures. That is why HFW also evaluates thyroid, cortisol, insulin, inflammation, nutrients, sleep, gut health, and mitochondrial function. (AUA Network)
Yes.
Exogenous testosterone can suppress sperm production. HFW reviews fertility goals before therapy and may discuss alternatives or timing considerations for men who want future fertility. (Endocrine)
Testing may include total testosterone, free testosterone, SHBG, LH, FSH, estradiol, CBC, hematocrit, CMP, PSA when appropriate, thyroid markers, insulin, glucose, HbA1c, lipids, inflammation, and body composition when needed.
Yes, when clinically appropriate.
HFW materials list testosterone injectable and testosterone cream options, with member and non-member monthly pricing. The right route depends on symptoms, labs, safety markers, lifestyle, preference, and provider judgment.
Some patients notice changes in libido, energy, mood, motivation, recovery, or training response within weeks.
More complex symptoms may take longer, especially when sleep, metabolic health, thyroid, inflammation, stress, medications, or nutrient status are also involved.
No. HFW is 100% telehealth.
Consultations happen virtually. Bloodwork can be coordinated locally when needed, and eligible prescriptions may be managed through appropriate pharmacy partners.
HFW operates on a cash-pay model.
HSA and FSA cards are accepted where applicable, and all major credit and debit cards are accepted.
