Testosterone Replacement Therapy (TRT) or what I have better coined Testosterone Optimization Therapy has changed the lives of millions of men, and many more are awakening to its awesome life-enhancing power.
Just in 2021 alone, the global TRT market reached a value of $1.5 billion million USD!
And while hypogonadism (i.e. low testosterone production due to deficient function in gonads or lack thereof) affects roughly 5 million men in the USA alone…
…worldwide testosterone deficiency is estimated to be anywhere between 10%-40%.
But one major barrier stopping men from taking the first step isn’t whether Therapeutic Testosterone will “work”, or if there are nasty side effects, or even the fear of needles ie injections.
The answer lies in the wallet: For many people, the cost of testosterone therapy simply proves to be too much.
They get intimidated by the price tags they see on the Internet, knowing full well they’ll have to pay them ON TOP of America’s ludicrous healthcare expenses.
Not to mention the “hidden” fees which often spring up at the last minute and would change the purchasing decision had it been known about from the start.
Which is why I’m writing this article to fully and transparently answer the following question:
“How much does testosterone optimization therapy cost, really?”
When you put together everything — additional medications, blood work, consulting fees, the testosterone itself — what is the final testosterone replacement therapy cost you should expect to pay when working with a Physician that KNOWS how to hormonally optimize you?
Stay tuned for the answer at the very end — it’s much more affordable than you think!
What is Testosterone Replacement Therapy (TRT)?
My working definition of “testosterone replacement therapy” (TRT) is the following:
The use of therapeutic-level doses of pharmaceutical-grade testosterone administered to your body exogenously (i.e. from outside your body to inside your body) in order to raise your natural (total and free) testosterone levels to optimal levels.
Because my idea of “optimal” testosterone levels is in the high-normal range (600-1400 ng/dL), I refer to this practice more accurately as “testosterone optimization therapy” (TOT).
Moreover, notice I use the clarifying moniker of “Therapeutic-level”, which is 100-200 mg delivered weekly (or in more frequent yet smaller doses).
This is a FAR CRY from what is used by pro-level bodybuilders, whom are using supraphysiological doses ranging anywhere from 500 mg to over 2000 mg of testosterone per week (alongside many other anabolic agents).
But why do all of this, you may ask?
Does this alone justify the testosterone therapy cost?
It absolutely does — for those of you who need a reminder of why testosterone is so vitally important:
“Testosterone, which is essential for the development and maintenance of organs and physiological functions in males, has many biological effects.
In males, this [steroid] hormone is produced by Leydig cells in the testes in response to luteinizing hormone from the pituitary gland.”
However, despite the knowledge of testosterone’s importance far beyond the development of men’s secondary sexual characteristics, we are still woefully unaware of how its natural decline negatively affects us as we get older:
“TRT in males with low concentrations of testosterone is controversial because this condition is often a normal sign of aging; testosterone concentrations in men naturally begin to decline at age 40 years, at an average of 1% to 2% per year.5
Clinical hypogonadism, however, is an approved indication for TRT and is the only FDA-approved indication for TRT in men.
The American Association of Clinical Endocrinologists (AACE) defines male hypogonadism as a decrease in testicular function (sperm or testosterone production) accompanied by signs or symptoms”
Several things wrong there…
- The 1-2% decline starts as early as age 30 (if not earlier)
- The siege on our endocrine systems by toxic environmental chemicals is destroying our hormonal health
- Unhealthy lifestyle habits can accelerate how fast the testosterone decline happens and how early it starts
Assuming you don’t have a medical condition contributing to low testosterone, the cycle that leads to lowered testosterone levels with older age is straightforward:
“As you age, your testicles produce less T [testosterone].
Lowered testicular T causes your hypothalamus to produce less gonadotropin-releasing hormone (GnRH).
Lowered GnRH causes your pituitary gland to makes less luteinizing hormone (LH). Lowered LH results in lowered overall T production.”
And as I highlighted in The TOT Bible, there are two types of low testosterone conditions (hypogonadism) you can suffer from:
- Primary hypogonadism — your testicles are unable to produce a sufficient amount of testosterone despite receiving “signals” from your brain to do so (due to genetics and/or injury)
- Secondary hypogonadism — your pituitary gland or hypothalamus, two parts of your brain controlling testosterone production, cannot properly signal your perfectly-working testes to produce testosterone
How to Get TRT
Before you can worry yourself sick about the cost of testosterone therapy, you first have to qualify for a physician’s official diagnosis of hypogonadism.
And then assuming this goes through, they will need to write you a prescription for testosterone.
Let’s go through the two steps in detail.
The Diagnosis of Low Testosterone
The first thing a physician will do is monitor all the symptoms of low testosterone you may be experiencing.
The list below isn’t comprehensive but it gives you an idea of what an experiential-based doctor who knows what he’s doing will look for:
- Lowered sex drive
- Issues with getting and/or keeping an erection (ex. erectile dysfunction)
- Reduced or non-existent sperm count
- Sharp decrease in muscle strength/mass, and/or an unusual inability to gain it
- Sharp increase in body fat, and/or an unusual inability to lose it
- Increase in breast tissue (i.e. gynecomastia)
- Loss of bone density
- Mental fatigue (ex. brain fog, difficulty concentrating)
- Overall low energy
- Lack of Motivation
- Lack of Passion/Drive
- Unusual moodiness/irritability
There are even standardized screening tools designed to determine if a man is suffering from low testosterone, such as the Androgen Deficiency in Aging Males (ADAM) test and the Aging Males’ Symptom (AMS) scale.
And answering “yes” to a certain number of questions — or to certain questions specifically — would be sufficient for an attending physician to determine you are suffering from testosterone deficiency.
The second thing a physician will do is run a blood test to get a more quantitative overview of your hormonal health.
While the first thing revolves around patient symptoms and how you feel on a day-to-day basis, this step is all about hard numbers.
We’ll talk about blood work in greater detail at a later point in this article, but for now, just know that most doctors will be looking to see if your total testosterone level is below 300 ng/dL (Source: The American Urological Association).
But this recommendation is fraudulent for numerous reasons.
First, based on my experience 300 ng/dL is way too far gone for any fully functional male.
From The TOT Bible:
“Our opinion is that anything under 400 ng/dL should be considered ‘low’ and confirmed clinically by a knowledgeable physician in the presence of the relevant symptoms.
As Jay already discussed in Chapter 6, the medical establishment has LOWERED the normal range as testosterone levels have dropped in the last 40 years, all due to a variety of reasons”
This is backed up by a 2015 study where hypogonadal symptoms started appearing as high as 400 ng/dL in younger men under 40:
“The probability of hypogonadal symptoms increased at a serum TT [total testosterone] level of 400 ng/dL.
A cluster of symptoms: two psychological (‘decreased energy’, ‘sadness’), and three physical (‘decreased strength and endurance’, ‘decreased ability to play sports’, and ‘deterioration in work performance’) were most strongly associated with serum TT levels of <400 ng/dL.
On multivariable analysis, only ‘lack of energy’ predicted a TT level of <400 ng/dL.
Conclusions: Hypogonadal symptoms in men aged <40 years can be associated with a TT level of <400 ng/dL. Of the hypogonadal symptoms evaluated with the ADAM questionnaire, ‘lack of energy’ appears to be the most important symptom that predicts a TT level of <400 ng/dL.”
Second, age MUST play a factor in any high-level physician’s evaluation of a patient.
Third, even if you factor in age, the idea of a “normal range” is a fallacy as the reference ranges used by the major blood lab measurement companies keep changing every few years to reflect how the average male is becoming increasingly more unhealthy:
“LabCorp’s physician panel had to accommodate a growing population that is now more obese and has lower testosterone levels on average. Remember, there is only a 6-year difference between the studies. In other words, they’re lowering their range of ‘normal’ total testosterone levels to reflect the epidemic of obese men with lower testosterone levels. Most people have noticed that the lower end of LabCorp testosterone reference range is now 264 ng/dL, whereas the previous lower end of the ‘normal range’ was 348 ng/dL.”
I highly recommend reading that old article of mine to better understand what you’re dealing with here.
The Prescription of Therapeutic Testosterone
So after taking an extensive medical history, submitting you to a questionnaire about your symptoms, and evaluating your blood lab tests for your testosterone readings (alongside many other hormones), your doctor will be ready to write you a prescription for testosterone to treat your newly-diagnosed hypogonadism.
It’s really the only legitimate way you will get it… at least in the United States since it is a Schedule 3 controlled substance.
(For the record, I believe many countries deem it illegal to buy testosterone without a prescription but there are some who do not.)
Putting aside legal consequences, pricey fines, and extended jail time, you’re taking an extremely huge gamble with your health(when buying underground or grey market testosterone).
Since you’re using unregulated testosterone that likely didn’t come from a legitimate compounding pharmacy, you have ZERO CLUE what is in it:
- Does it adhere to recognized safety standards?
- Is the bottle of testosterone impure and contaminated with other ingredients that can damage your health in unknown ways?
- Is the testosterone itself expired or lower in concentration due to improper short-term or long-term storage?
You should ask yourself if you’re attempting to save a few bucks that you would have spent anyways on 100% pharma-grade bio-identical testosterone.
Because if you are, keep on reading the article and you’ll see why you’re better off avoiding the black market if at all possible.
(Clearly in some countries, attaining Therapeutic Testosterone from approved medical channels is IMPOSSIBLE).
How Much Does Therapeutic Testosterone (TRT) Cost?
How expensive is Testosterone Optimization for the average biohacker, really?
What is the total testosterone therapy cost when you factor in EVERY single variable affecting the number you see at the bottom of your medical bill?
The short answer is “It depends entirely on numerous factors that are in and out of your control”.
The long answer involves listing out every single one of those factors, which include the following:
- Location – obviously you would pay more if you are living in California compared to Arkansas
- Whether you are using a brand name or generic version for therapeutic testosterone (the same goes for other ancillary medications you may be taking alongside testosterone)
- The nature of your testosterone therapy – pills, gels, creams, injections (ex. injections have an additional cost of buying syringes and needles)
- The severity of low testosterone symptoms – additional medications may be needed alongside testosterone
- Dosage of testosterone taken – do you need more or less testosterone on a weekly basis?
- Duration of treatment – testosterone therapy is a LIFELONG commitment as your body needs constant adjustment of dose and frequency due to no longer producing an adequate amount of testosterone naturally
- The anti-aging clinic you sign up with
- Your insurance plan and your copay (if any)
- The number of visits you make to your anti-aging clinic
- The number of blood tests needed outside of what is usually prescribed to patients with low testosterone
- The cost of the initial consultation
So many factors involved in one’s individual TRT costs, not to mention they can fluctuate from month-to-month and even week-to-week!
Therefore, you’ll come to appreciate I can’t give you a definitive answer.
What I can do is give you a reasonable range of what you should expect to pay and reveal how the final cost of testosterone therapy per month (or per year) is an investment, but not one that breaks the bank.
Blood and Lab Tests
I don’t care who you are or what TOT physician you are working with: Blood labs are MANDATORY in order to accurately gauge the state of the health and determine if what you are doing is truly working.
And being someone who has extensively tracked my vital biomarkers every 6-12 months since the young age of 29, the only provider I would feel comfortable recommending is Private MD Labs.
I’ve used them for over 15 years and it’s never been easier or more affordable to collect your blood work. (Right now Private MD Labs are only available in the USA but they are expanding soon).
No doctor appointment or awkward conversation necessary… you just choose the panel you want, choose where and when you want the test to be done, pay online, go to the testing site, draw your bloods, and your results will be available within a week or less.
Use my affiliate link and get 15% off your order with code JayC
The affiliate link will also show you my three must-have panels for beginner, intermediate, and advanced users of TOT alongside the exact markers tracked by each panel.
Prices range from $290 for the Basic Panel to $700 for the Advanced Panel.
Private MD Labs would be roughly in the middle to upper-middle of the total range of costs I have seen for blood work, which goes anywhere between $100-500 depending on the clinic/doctor you work with and the number of biomarkers you are measuring.
This is where things can get a little bit tricky, so pay close attention.
The popular business model for TRT clinics — especially those in the telemedicine field — is to charge you a monthly subscription rate that includes “everything”.
From The TOT Bible:
“On the more expensive side, an anti-aging clinic can charge as much as $250-1,250 for an initial consultation, along with a monthly membership fee ($99-350) to allow their patients to obtain a prescription for testosterone, various anti-aging medications, and concierge (VIP) access to the physician.
Other clinics will simply charge a fee to speak with a doctor or nurse, and medications will be prescribed so that you can be reimbursed through your health insurance (when covered).”
More specifically, the monthly rate will cover one, several, or all of the following:
- Regular visits to the clinic / consultations via telemedicine to review your progress and current health status
- Your blood tests that must be done every 6-12 months
- At-home delivery of everything you need to optimize your hormones, which includes testosterone, the tools needed to administer the testosterone, and any additional medications required
- Blood draws and injections (if you do them on-site instead of handling them yourself at home)
- Additional support from the clinic’s medical team
But you should expect to pay anywhere from $120-500 per month if you are signing up with one of these clinics.
However, this cost range comes with some caveats:
- Some clinics will charge you a more expensive “initial consultation fee”, followed by the monthly subscription fee
- Some clinics do not include additional medications in the monthly fee and charge for them on top of the monthly fee
- Watch out for clinics who are NOT fully transparent about the costs of ALL services and treatments, along with any fees not officially discussed and written on paper
I want to emphasize the second point as medications like Metformin, Amour Thyroid, HCG, growth hormone and various peptides others can rack your bill up quickly if you don’t have insurance and/or don’t know where to look for the best prices.
There are other telemedicine optimization clinics who forego the monthly subscription model and give you the option to only pay for select medications and Doctor related consultation services whenever you desire them.
I personally like this business model and IMO, the folks doing this the best are Medical Health Institute of Miami.
If you are interested in me personally recommending them to you, send me an email with the subject line: MHI Referral
In this section, I want to talk about the ONLY two forms of testosterone worth using: Intramuscular injections (Every other Day or Daily) and trans-scrotal cream.
To be more specific, I’ll copy and paste my recommendations for both modalities from my recently published “God Stack” article:
- Subcutaneous daily or EOD injection of a testosterone ester such as cypionate or propionate (I spent 18 years using every-other-day injections for a total of 150 mg of injectable testosterone per week)
- A compounded trans-scrotal testosterone cream (200 mg of testosterone per gram of cream 200 mg/g with Versa base or HRT base) applied 1-2x/day to a clean, shaven and dry scrotum*
With respect to the creams, I’ll quote The TOT Bible yet again to give you a realistic expectation of how much the trans-scrotal cream costs:
“If your insurance doesn’t cover branded transdermal testosterone gels, you typically have to pay $300-400 out of pocket every month.
Compounded transdermal creams are about 1/8th the cost, so there are significant cost savings.”
I’ve also seen creams go anywhere between $200-500 a month depending on the clinic, so buyer beware when you’re going down this route.
But where I really want to direct my attention to are the injectables.
According to this 2017 paper covering the costs of all available testosterone treatments, here are the approximate costs of injecting testosterone per month if you’re just paying for the testosterone alone:
- Testosterone cypionate – A 10 mL vial concentrated at 200 mg/mL will cost you $145-215, which at one injection per week comes out to $56-$80/month
- Testosterone enanthate – A 10 mL vial concentrated at 200 mg/mL will cost you $Same, which at one injection per week comes out to $Same/month
These are the costs of the shots without insurance, so it’s in your best interest to have your provider working in your favor.
The Average Total Cost of Testosterone Optimization Therapy
I’ve long said that if you cannot afford $3,000-$10,000 per year AT A MINIMUM to fully invest into optimized health, your priorities are out of wack.
You must either (a) start making more money or (b) take an honest look at your spending and see where you are wasting your funds.
This estimate falls in line with what I’ve seen with respect to the estimates put forth by other clinics.
I’ll quote a good summary I found below from another clinic as I believe it gives the most realistic expectation with respect to the range of yearly costs I’ve seen for EVERYTHING involved with proper TOT:
“Combining the cost of medications, labs, as well as medical services and supplements, it’s not uncommon for treatment to average anywhere between $2100 to $5000 for the first year and from $900 to $1800 every year thereafter.
This cost will depend on the extent of insurance prescription coverage as well as which prescriptions are required. That said, these costs should fall over time.
The initial outlay is often higher, as the amount of lab work and consultations required to track the root cause of your symptoms, and then tailor a plan to suit, are time-intensive tasks. “
As you can see, the estimated testosterone therapy cost is not cheap but by no means is it too expensive or intimidating for anybody who regularly reads my content.
Does Insurance Cover Testosterone Therapy?
Just like my estimate of the total costs of testosterone therapy you should expect to pay per year, my answer to this question is “it depends”.
And I say this for the main reason that some insurance companies are more lenient than others.
Some insurance companies will stop covering your treatment once your testosterone levels go from sub-optimal to optimal, let alone “normal”.
At the same time, insurance companies consider TRT as a “cosmetic procedure” and not one that’s mandatory for health, therefore providing zero coverage (you may not die tomorrow and perhaps not suffer any major complications, but your quality of life will be negatively impacted).
This means your low testosterone has to be the result of a REAL medication condition (ex. Klinefelter syndrome) in order for your TRT to be covered by insurance.
What makes this matter particularly difficult is that insurance companies are not known for being fully transparent about what treatments they will/won’t cover, the criteria used to make this judgment, and to what extent they will partially or fully cover the treatments.
Which means one insurance company may cover blood work but not your physician visits, while another refuses to cover blood work yet helps cover the costs of your physician visits.
To make a long story short: You can generally expect a good insurance provider to cover SOME of the costs that come with your TRT protocol while paying out-of-pocket for the rest of them.
Bottom Line: Almost all legitimate Therapeutic Testosterone prescribing Doctors and their clinics DO NOT ACCEPT INSURANCE, as they don’t want to be a party to any of the nonsense I just mentioned.
There you have it – everything you need to know about the testosterone therapy cost you can expect to pay on a monthly and annual basis.
Your personal health circumstances and your budget will largely dictate which clinic you work with, which ancillary medications you will use in addition to therapeutic testosterone, and what payment plan you will opt for.
But I think all of this is a very small price to pay — fully optimized health is a worthwhile investment that pays off 100x, both now and in the future.
And given we are in an age where enhancing your testosterone levels naturally is no longer an option, why do things the hard way?
Of course… if all of this is brand new to you and overwhelming to take in, your first step should be to download a FREE PDF copy of The Top 10 Questions to Ask Your Doctor About Therapeutic Testosterone:
Make sure you follow along with the email sequence that gets sent to your inbox when you download the PDF, because included in one of the emails will be a 50%-OFF discount code for my premium course TOT Decoded!
This course is +30 years of my personal knowledge about everything related to testosterone in an easy-to-access digital course that comes with checklists, client case studies, summaries, and exclusive guides to provide you with state-of-the-art insights on using Therapeutic Testosterone for lifelong health and happiness.
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