What is testosterone replacement therapy?

Testosterone replacement therapy is a form of hormone therapy used to counter the effects of low testosterone, known as hypogonadism, in men and women.

Patients undergoing testosterone replacement therapy supplement or replace their natural production with exogenous testosterone and other hormones.

For more information on TRT for men, read this. For more information on TRT/HRT for women, read this.

Is testosterone replacement therapy safe?

Testosterone replacement therapy is safe when you work with competent, experienced doctors who strictly adhere to evidence-based standards and proper patient care.

At Tier1 Health & Wellness, we don’t use cookie-cutter, one-size-fits-all protocols. We also refuse to treat you based on what you read on random internet forums or any fads you may have come across.

We understand that each patient is unique and as such, your treatment must be customized based on how you feel, your biomarkers, and any symptoms or side effects you may experience.

How do I know if I have low testosterone?

At Tier1 Health & Wellness we use a qualitative and quantitative approach.

The qualitative approach is based on how the patient feels. Do they have brain fog, low libido or low energy? Do they lack ambition and drive? Do they lack motivation to do things they used to enjoy doing? Do they have trouble keeping the weight off? Do they have difficulty gaining muscle when strength training? Do they injure frequently and heal slowly? Are they quick to become irritable around friends and family? Any of these could be indications that someone is suffering from low testosterone.

The quantitative approach is based on a patient’s blood work. We use lab results in tandem with the patient’s symptoms, and not in isolation. This is because every individual is unique and what is “low testosterone” for one man or woman will be “normal” for another. This also applies when treating patients. One patient may need higher testosterone levels to feel good while another needs less.

I’m a woman in my 30s. Do I need hormone replacement therapy?

It depends on how you feel. Are you experiencing symptoms related to hormone deficiency? For example, are you easily irritable? Do you have hot flashes? Is your sex drive low or non-existent? Are you having trouble keeping the weight off? Do you feel frail or are your bones weak? Do you have low energy during the day?

We generally recommend all women mid-30s and older get some form of hormone supplementation or support. In our experience, women on hormone therapy have an easier time during pre-, peri- and post-menopause, and reduce or eliminate the difficulties associated with that period of their lives.

Women are also more hormonally “complicated” than men, and require extra care when balancing their hormones. Tier1 Health & Wellness has extensive experience treating women with hormone replacement therapy. And several of the women on our team are on hormone therapy. We understand what women go through based on our own personal experiences as well as those of our patients.

In addition to the above, we also treat younger women dealing with Polycystic Ovarian Syndrome (PCOS.) Some women develop PCOS as early as in their teens. For more about our approach to treating PCOS, read this.

I’m a man in my 20s with low testosterone. Can you treat me?

While we don’t turn away people who need our help, we prefer to work with men 30 and older for the reason that testosterone replacement therapy is a long-term commitment.

Men in their 20s are young enough that, barring exceptional cases, they can more easily optimize their hormones via lifestyle changes like exercise, nutrition, sleep, etc. than men in their 40s and older.

That being said, if you’ve tried and exhausted lifestyle measures and symptoms of low testosterone persist, book a free consultation here and let’s talk.

How fast will I see results when I start TRT/HRT?

Every patient is different. How fast you respond to hormone therapy is unique to you. Some of our patients start feeling better overnight. Others need weeks, sometimes months, before they see any noticeable improvement. We keep going until we see the desired effect.

This is also why a bespoke treatment protocol, supervised by an experienced practitioner, is essential. When you work with Tier1 Health & Wellness, we promise that your customized treatment protocol will be the best one for you and get the fastest results for you.

Will I get “roid rage” when I start TRT?

No, you won’t get “roid rage.” What is referred to as “roid rage” can be attributed to the abuse of anabolic steroids, which are synthetic drugs that mimic testosterone, and exacerbated by pre-existing psychological issues.

When on TRT you’re taking a hormone your body produces naturally, testosterone. You’re not taking anabolic steroids. You will also be under the supervision of an experienced, expert practitioner like Dr. Keith Nichols, who will monitor your reaction to the treatment protocol and make any necessary adjustments.

How much does TRT/HRT cost?

Ballpark: expect to invest $300-500/month into your long-term health and well-being.

You’ll have to pay for labs. The initial lab tests will be more expensive since we need a full set of blood work. Subsequent labs will be cheaper because we need to test for less.

You’ll have to pay for prescriptions, which will depend on your customized treatment protocol. So, the cost varies from patient to patient.

How much you’ll pay for consultation and follow-ups will depend on your healthcare provider. At Tier1 Health & Wellness, we take a deposit for the initial consultation with Dr. Keith Nichols. If you decide to become a patient, that deposit is then applied to your annual enrollment fee. The enrollment fee can be paid up-front or on a payment plan. This is an all-inclusive subscription to work with Dr. Nichols. You won’t have to pay extra to talk to us. Labs and prescriptions are an additional cost.

We’re also pleased to offer a generous discount on our annual enrollment fees to military, police, and firefighters.

How to Enroll in Our Telemedicine Program


Schedule a Consultation

Complete the form on this page and one of our team will call you back to help you get started on your optimization journey.


Physical & Lab Work

Get a physical exam from a healthcare provider near you and we will order the necessary bloodwork


Telemedicine Appointment

We’ll schedule your first telemedicine appointment.



We’ll enroll you in our program. Military, law enforcement, and firefighters get discounted rates. We also have convenient payment plans.


Custom HRT Plan

Based on your lab work and symptoms, we’ll create a custom BHRT plan that will be monitored and adjustments made monthly until your symptoms are resolved.


Follow up

You’ll have unlimited access to our HIPPA compliant patient portal and phone appointments at no additional charge. Any time you want to talk to us, we’re here for you.

Your Life Without Optimized Hormones

  • Weight gain, especially in midsection
  • Loss of lean muscle mass
  • Degenerative disease (diabetes, cancer, heart disease, osteoporosis)
  • Compromised immune system
  • Thinning of the skin.
  • Depression and stress
  • Cognitive decline/forgetfulness
  • Insulin resistance
  • Loss of sex drive
  • Fatigue
  • Sleep disorders
  • Muscle aches and pains
  • Bone loss
  • Heat/cold intolerance
  • Indecision
  • Erectile dysfunction
  • Thinning hair
  • Irritability
  • Hot flashes
  • Heart palpitations
  • Vaginal dryness


I’ve recommended hundreds of people to Tier1 Health & Wellness. If you’re a man or woman who’s looking to get your hormones optimized… I give them my highest endorsement

Jay Campbell

Best-selling author of the Testosterone
Optimization Therapy Bible


Schedule Your Free Consultation

Ready to get started? Just want to talk to a real person? Enter your details in the form and someone from our team will call you back within 24 hours.