How Much Does TRT Cost in Ann Arbor - and What Monitoring Is Included?

New to TRT? Start with our main guide: Testosterone Replacement Therapy for Men in Ann Arbor - benefits, risks, candidacy and what to expect. This page covers one narrower question: cost and monitoring.

Most men researching testosterone therapy find plenty written about how it feels and almost nothing about what it costs or what is actually checked once you start. That gap is where poor programs live. A low headline price usually means the monitoring was removed, and the monitoring is the medicine.

This page lays out both sides of the ledger at Arbour Longevity in Ann Arbor: what you pay, what is included, what is billed separately, and the exact schedule of labs your protocol is adjusted against.

What Testosterone Therapy Costs at Arbour Longevity

The first visit

Your first consultation is $35, and that fee is applied toward your treatment. It is a private, unhurried assessment with Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC, a triple board certified nurse practitioner, covering your symptoms, your history, and which labs make sense for your picture.

The ongoing program

Arbour Longevity's hormone optimization and BHRT program starts at $299 per month. That price includes:

• Your clinical consultations and ongoing medication management
• Your testosterone prescription and protocol adjustments
• Four B12 injections and four lipotropic shots per year
• Thyroid and broader hormone optimization where your labs indicate it
• Direct access to your prescriber between visits

Labs are billed separately, deliberately and transparently. Orders go to your nearest LabCorp or Quest, where many patients have partial insurance coverage even though the clinic itself is cash-pay.

Why cash-pay, and how to offset it

Arbour Longevity is a cash-pay practice. That is what buys the longer appointments, the fuller panel, and treatment decisions made on clinical judgment rather than a formulary. HSA and FSA funds are accepted, and the clinic provides itemized receipts you can submit for possible out-of-network reimbursement.

What changes the total

Two things move your real annual cost: how often you need labs in the first year (more at the start, fewer once you are stable), and which delivery method you choose. Injections are the least expensive per month; pellets carry a higher per-procedure cost a few times a year; gels sit in between. The full comparison lives in testosterone pellets vs injections vs gels.

What Monitoring Is Included - and on What Schedule

The Endocrine Society's clinical practice guideline is explicit that men on testosterone therapy should be followed with a standardized plan that evaluates symptoms, side effects and adherence, measures serum testosterone and hematocrit, and assesses prostate cancer risk during the first year of treatment (Bhasin et al., J Clin Endocrinol Metab 2018, DOI: 10.1210/jc.2018-00229). That is the floor, not the ceiling, and it is what your monthly fee is buying.

The monitoring calendar

• Baseline, before your first dose: the full panel below, so every later result has something to be compared against.
• Weeks 6 to 12: the first recheck. This is where dose is corrected, not guessed at.
• Every 3 to 6 months after that: ongoing surveillance, tightened if anything drifts.

What gets measured, and why

• Total and free testosterone - confirms you are in the intended range rather than under- or over-shooting it
• Hematocrit and full CBC - the single most common lab change on testosterone, covered in detail below
• Estradiol (E2) - testosterone converts to estrogen, and symptoms appear at both ends of that range
• SHBG - determines how much of your total testosterone is usable at all
• PSA - baseline and ongoing prostate surveillance, particularly over 40
• Comprehensive metabolic panel and lipids - liver, kidney and cardiometabolic safety
• HbA1c - because metabolic health and testosterone move together
• Thyroid panel - so a thyroid problem is not quietly treated as a testosterone problem

If you want to understand what each of those numbers means on your own report, read free vs total testosterone and how to read your lab panel.

Hematocrit on TRT: The Number Watched Most Closely

Testosterone stimulates red blood cell production. That is a normal, expected effect of the hormone, and it is why hematocrit is checked at every monitoring interval rather than occasionally.

A long-term cohort study of 1,073 people receiving testosterone therapy found that hematocrit rose most steeply during the first year of treatment - from a mean of 0.39 L/L at baseline to 0.45 L/L at twelve months - and that the probability of crossing a hematocrit of 0.50 L/L kept climbing with cumulative years of exposure. Tobacco use, higher body mass index, older age at initiation, and long-acting injectable preparations were each associated with higher odds of reaching that threshold (Madsen et al., J Clin Endocrinol Metab 2021, DOI: 10.1210/clinem/dgab089).

Two practical points follow from that evidence, and both are built into the program:

• Front-load the checks. The steepest change happens early, so the 6-to-12-week recheck matters more than any later one.
• It is manageable. A rising hematocrit is usually addressed with a dose reduction, a change of delivery method, therapeutic phlebotomy or blood donation, and attention to smoking and weight - not by abandoning treatment.

That same cohort found switching to a transdermal route, stopping smoking and reducing body weight to be reasonable first responses when hematocrit climbs, which is precisely the kind of adjustment a monitored program can make and an unmonitored one cannot.

Cardiovascular Monitoring: What the Evidence Actually Supports

The TRAVERSE trial randomised 5,246 men aged 45 to 80 with symptomatic hypogonadism and either existing or high-risk cardiovascular disease to daily transdermal testosterone gel or placebo. Over a mean treatment duration of 21.7 months and a mean follow-up of 33.0 months, testosterone was noninferior to placebo for the primary composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke (hazard ratio 0.96; 95% CI 0.78 to 1.17). The trial did record a higher incidence of atrial fibrillation, acute kidney injury and pulmonary embolism in the testosterone group (Lincoff et al., N Engl J Med 2023, DOI: 10.1056/NEJMoa2215025).

That is a reassuring headline with specific, named signals attached - and those signals are the argument for exactly the monitoring schedule above. Baseline and ongoing kidney function, awareness of clotting risk, and attention to any new palpitations are part of routine follow-up here.

What You Get That a Low-Cost Program Usually Removes

When a testosterone program is priced well below a monitored one, something has been taken out. Usually it is one of these:

• A baseline panel broad enough to catch a thyroid, metabolic or sleep cause before testosterone is prescribed
• The 6-to-12-week recheck, which is where most dose corrections happen
• Estradiol and SHBG, without which symptoms on treatment cannot be interpreted
• A named prescriber who knows your case, rather than whoever is on shift
• Protocol adjustment - the willingness to change dose, frequency or delivery method when your labs or symptoms say so

Arbour Longevity does not set and forget. That phrase does a lot of work in marketing copy; here it means a scheduled recheck with your name on it.

Before You Pay: Make Sure Testosterone Is the Right Answer

Cost only matters if the treatment fits. Before committing to a monthly program, it is worth confirming three things:

• Your symptoms genuinely match testosterone deficiency - see low testosterone symptoms in men
• Your labs confirm it on two morning draws, with free testosterone and SHBG included - see how to read your lab panel
• You are a candidate, and nothing else explains the picture better - see who is and isn't a candidate for TRT

Testosterone therapy sits inside Arbour Longevity's broader hormone optimization program, and you can read more about the clinic's approach to hormone replacement therapy in Ann Arbor.

Frequently Asked Questions About TRT Cost and Monitoring

How much does TRT cost per month?

Arbour Longevity's hormone and BHRT program starts at $299 per month, including consultations, medication management, protocol adjustments, and four B12 and four lipotropic injections per year. Labs are billed separately through LabCorp or Quest.

What does the first visit cost?

$35, applied toward your treatment plan.

Are labs included in the monthly price?

No, and that is intentional. Lab orders go directly to LabCorp or Quest so you see the real cost and can use any partial insurance coverage you have. Bundling them into a monthly fee tends to hide how few are actually being run.

Do you accept insurance, HSA or FSA?

Arbour Longevity is a cash-pay practice. HSA and FSA funds are accepted, and itemized receipts are provided for possible out-of-network reimbursement.

How often will I need bloodwork?

A baseline panel before starting, a recheck at 6 to 12 weeks, then every 3 to 6 months once you are stable. More often if a marker such as hematocrit needs closer attention.

What happens if my hematocrit rises?

It is managed, not ignored. Options include lowering the dose, spacing or changing the delivery method, therapeutic phlebotomy or blood donation, and addressing smoking and body weight. It is caught by routine bloodwork long before it becomes a problem.

Is the monitoring the same for pellets, injections and gels?

The markers are the same. The timing shifts slightly with the delivery method, since pellets and gels produce steadier levels while injections have a peak and trough. See pellets vs injections vs gels.

Can any of this be done by telehealth?

Yes. Initial and follow-up appointments are available by telehealth across Michigan, with labs ordered to your nearest LabCorp or Quest. In-person visits at the Ann Arbor clinic cover anything hands-on, such as pellet insertion.

Book Your $35 Consultation

If you want a straight answer on what testosterone therapy would cost you and what would be tracked, one visit and one panel will give it to you.

Book your $35 first-visit consultation with Arbour Longevity, or call (734) 436-3357.

Arbour Longevity, 2217 Packard St #15, Ann Arbor, MI 48104. Open Thursday through Monday, 10:00 to 19:00, closed Tuesday and Wednesday. Parking is free and directly outside - no meters and no parking structure. Suite 15 is down a flight of stairs, so please call ahead if stairs are difficult for you and we will make arrangements. Serving Ann Arbor, Ypsilanti, Saline, Dexter, Chelsea and Washtenaw County, with telehealth across Michigan.

References

1. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID 29562364. DOI: 10.1210/jc.2018-00229
2. Madsen MC, van Dijk D, Wiepjes CM, et al. Erythrocytosis in a Large Cohort of Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years. J Clin Endocrinol Metab. 2021;106(6):1710-1717. PMID 33599731. DOI: 10.1210/clinem/dgab089
3. Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med. 2023;389(2):107-117. PMID 37326322. DOI: 10.1056/NEJMoa2215025

Pricing is current at the time of writing and confirmed at your consultation. This article is educational and does not replace individualized medical advice. Testosterone therapy requires clinical evaluation, lab testing and ongoing monitoring by a licensed prescriber.