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Hormone Optimization · Ann Arbor

Testosterone Therapy for Men

Energy ◆ Strength ◆ Mental clarity ◆ Mood ◆ Libido ◆ Sleep ◆ Body composition ◆ Each one is regulated by your hormones ◆ At Arbour Longevity, we don’t just test your levels; we optimize them.

Schedule a Hormone ConsultationTake our Hormone Quiz

Man building strength and endurance after testosterone therapy

Benefits, Process & Programs

Do You Recognize Yourself Here?

Hormone imbalance is rarely dramatic. It's the slow accumulation of symptoms that each seems explainable on its own, until you realize they all point to the same root cause.

Men: Common Signs of Imbalance

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Persistent fatigue that sleep doesn't resolve

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Loss of muscle mass despite regular exercise

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Abdominal fat gain that won't respond to diet

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Declining libido or sexual performance

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Brain fog, poor concentration, and memory lapses

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Mood changes, irritability, or low motivation

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Difficulty sleeping or poor sleep quality

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Reduced strength and athletic recovery

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Loss of competitive drive or sense of purpose

Experiencing more than three of these symptoms is clinically significant. It's time to look at the full hormonal picture.

Our Hormone Quiz takes 2 minutes and gives you a personalized assessment, along with your recommended next step.

Take our Hormone Quiz

Your Lab Panel

What We Test. Why It Matters.

Your conventional doctor likely ran TSH and total testosterone. We order a complete panel because treating hormones without full context is guesswork.

Biomarker

Why We Test It

Panel

Total & Free Testosterone

The primary androgen, drives energy, libido, muscle, and mood in both sexes

Core

Estradiol (E2)

Critical for bone density, mood, cognition, and cardiovascular health in men and women

Core

Progesterone

Sleep quality, anxiety regulation, and hormone balance, especially in women

Core

TSH, Free T3, Free T4

Full thyroid picture: TSH alone misses subclinical dysfunction

Core

DHEA-S

Adrenal reserve, energy, immune function, and precursor hormone production

Core

Cortisol (AM)

Adrenal health, stress response, and metabolic function

Core

Pregnenolone

The “mother hormone,” a precursor to all steroid hormones, including testosterone and cortisol

Core

SHBG

Sex hormone binding globulin determines the bioavailability of testosterone and estrogen

Core

Reverse T3

Identifies thyroid conversion issues missed by standard panels

Extended

IGF-1

Growth hormone proxy: key for body composition and longevity assessment

Extended

CBC, CMP, Lipids, HbA1c

Metabolic baseline: essential for a complete clinical picture and safety monitoring

Extended

Common Questions

What Patients Ask Us Most.

What's the difference between "normal" and "optimal" hormone levels?

Lab reference ranges reflect the average population, which includes a large number of people who are symptomatic, sedentary, or aging without optimization. At Arbour Longevity, we target the range at which patients consistently report peak energy, clarity, and performance. That range is often significantly higher than what a conventional provider considers acceptable.

Is hormone therapy safe?

When prescribed and monitored by a qualified clinician, bioidentical hormone therapy has an a strong safety record when monitored. Every Arbour Longevity patient receives regular lab monitoring to ensure levels remain in the optimal and safe range. We never set and forget. Ongoing oversight is built into every protocol.

Do you offer testosterone therapy for women?

Absolutely. Low testosterone in women is one of the most underdiagnosed contributors to fatigue, low libido, cognitive decline, and muscle loss. Our female hormone protocols include testosterone alongside estrogen, progesterone, DHEA, and thyroid, the complete picture that most providers miss.

How long before I feel results?

Most patients notice initial improvements in energy and sleep within 2–4 weeks. Libido, body composition, and cognitive changes typically become evident at 6–12 weeks. Full optimization, where all biomarkers and symptoms align, generally occurs at 3–6 months with appropriate protocol adjustments along the way.

Do you accept insurance?

Arbour Longevity operates as a cash-pay practice, which allows us to provide the depth of care and personalization that insurance-based medicine cannot accommodate. We accept HSA and FSA funds, and provide detailed receipts for potential out-of-network reimbursement. Lab orders are sent to LabCorp or Quest, where many patients have partial coverage.

Can I do my consultation via telehealth?

Yes. Initial consultations and follow-up appointments are available via telehealth for patients throughout Michigan. Lab work is ordered to your nearest LabCorp or Quest location. Procedures requiring in-person visits, such as pellet insertion, are performed at our Ann Arbor clinic.

Testosterone Therapy & TRT in Ann Arbor

Testosterone in men declines roughly one to two percent per year after age thirty. By the mid-forties the effects are usually hard to ignore: fatigue that sleep does not fix, muscle that is harder to build and easier to lose, weight settling around the middle, flat mood and motivation, and a libido that has quietly disappeared.

Arbour Longevity provides testosterone replacement therapy in Ann Arbor built on comprehensive laboratory testing, not a symptom questionnaire. Protocols are designed and monitored by Gandhi Bhattarai, FNP-BC, PMHNP-BC, a triple board certified nurse practitioner, with delivery by injection, cream or pellet depending on what suits your life.

What proper TRT monitoring involves

Responsible testosterone therapy is not a standing prescription. Alongside total and free testosterone we track estradiol, because testosterone converts to estrogen and an unmanaged ratio causes its own problems. We track hematocrit, because testosterone thickens blood. We track PSA. And we discuss fertility before starting, because testosterone suppresses natural production — a consequence many online prescribers never mention to men who still want children.

Why the labs go wider than testosterone

Thyroid dysfunction, insulin resistance, poor sleep and elevated cortisol produce symptoms almost identical to low testosterone. Treating testosterone alone while one of those is the real driver produces disappointing results and an unnecessary lifelong prescription. Our panel covers thyroid with Free T3 and Free T4, DHEA-S, cortisol, fasting insulin, HbA1c and inflammatory markers alongside the full sex hormone picture.

Arbour Longevity is at 2217 Packard St #15 in Ann Arbor, serving Ypsilanti, Saline, Dexter, Chelsea, Brighton and Washtenaw County, with telehealth follow-up across Michigan. Your first visit is $35, applied toward your treatment plan. HSA and FSA cards accepted. Call (734) 436-3357.

Begin Your Hormone Journey

Your First Step Is a Conversation

Schedule a hormone consultation, in-person in Ann Arbor or via telehealth. We'll review your symptoms, your goals, and design the right lab panel to give us the full picture before we recommend anything.

Schedule Hormone ConsultationTake our Hormone Quiz

Clinician-led longevity practice based in Ann Arbor, Michigan.

Now accepting new patients from Ann Arbor, Saline and across Washtenaw, Livingston, Wayne, Oakland, Monroe, and Jackson Counties throughout Southeast Michigan.

What TRT Costs at Arbour Longevity

Most clinics make you book a consultation to find out what testosterone therapy costs. We publish it, because you should be able to decide whether this fits your budget before you take time off work.

Testosterone Replacement Therapy

$299/month

Includes your consultations. No separate visit fees, no per-appointment charges.

Clinician-directed protocol design
Ongoing lab monitoring and dose adjustment
Consultations included in the monthly fee
Telehealth follow-ups for Michigan patients

Hormone Pellet Therapy

$1,199/insertion

Each insertion covers approximately three months. Consultations are free every three months at reinsertion.

In-office subcutaneous insertion
Steady release without weekly dosing
Roughly $400/month equivalent
Follow-up consults at no additional charge

HSA and FSA funds are accepted. Lab work ordered through LabCorp or Quest may carry partial insurance coverage depending on your plan. Arbour Longevity operates as a cash-pay practice and provides receipts for potential reimbursement.

Injections, Pellets, or Cream — Which Fits You

There is no single best delivery method. There is a best method for how you actually live, and that is the conversation we have at your first visit.

	Injections	Pellets	Topical Cream / Gel
Frequency	Weekly or twice weekly	Every ~3 months	Daily
Where	Self-administered at home	In-office insertion	At home
Level stability	Peaks and troughs between doses; twice-weekly dosing smooths this considerably	Steadiest of the three	Reasonably steady, but absorption varies between individuals
Adjustability	Easiest — dose can be changed week to week	Hardest — once inserted, the dose is fixed until it wears off	Easy
Main drawback	You have to be comfortable with a needle	Minor in-office procedure; small risk of extrusion or site irritation	Transference risk to partners and children through skin contact
Cost here	$299/mo, included	$1,199 per insertion	$299/mo, included

Transference is the reason many men with young children at home rule out topicals. It is a real consideration, not a sales point — testosterone transferred by skin contact can cause genuine harm to a child.

Fertility matters here too. Exogenous testosterone suppresses the body's own production and can meaningfully reduce sperm count. If you are planning to father children now or later, say so at your first visit — protocols that preserve fertility exist, and that decision needs to be made before starting, not after.

Signs Worth Getting Tested For

Low testosterone rarely announces itself. It usually shows up as a slow accumulation of things you have written off as getting older, being busy, or not sleeping well.

Energy & Drive

Persistent fatigue that sleep doesn't fix. Loss of competitive drive or motivation. Feeling flat about things that used to matter.

Body Composition

Losing muscle despite training. Gaining fat, particularly around the midsection. Strength plateauing or going backward.

Sexual Health

Reduced libido. Weaker or less frequent morning erections. Erectile changes — which can also be an early cardiovascular signal worth investigating.

Mood & Cognition

Irritability, low mood, or a shorter fuse. Brain fog, or difficulty holding focus through a workday.

Sleep & Recovery

Poor sleep quality. Longer recovery after training or illness. Waking unrefreshed.

Physical Signs

Reduced body or facial hair growth. Bone density loss on imaging. Decreased testicular size.

Every one of these has causes other than low testosterone — thyroid dysfunction, sleep apnea, depression, anemia, and medication side effects among them. That is precisely why the evaluation comes before the prescription.

The Lab Evaluation

We do not run a fixed panel on everyone. What gets tested is determined by your symptoms, history, medications, and what we are trying to rule in or rule out — then adjusted as your results come back.

What is consistent is the principle: testosterone is never interpreted in isolation. A total testosterone number on its own tells you very little. How much of it is bioavailable, how it is being converted, what your pituitary is signaling, and whether something else entirely is driving your symptoms all matter more than a single figure on a lab report.

Where the evaluation points to something other than hypogonadism — thyroid disease, sleep apnea, a medication effect — we tell you that, and we address it. Starting testosterone in a man whose real problem is untreated sleep apnea does not help him.

Normal versus optimal

Standard lab reference ranges reflect the general population, which includes a great many men who are symptomatic, sedentary, and aging without intervention. Falling inside the reference range does not automatically mean your levels are right for you. We treat the patient in front of us alongside the numbers, targeting the range where you actually function well — while staying within safe, monitored physiologic limits.

How to Start

Labs

Baseline bloodwork ordered through LabCorp or Quest, drawn at a location convenient to you.

Your first visit is in person

Starting testosterone therapy requires an in-person visit at our Ann Arbor clinic. This is a deliberate clinical standard, not a scheduling preference — a physical exam and a face-to-face conversation matter before initiating a controlled substance you may be on long-term.

Protocol design

Delivery method, starting dose, adjunct therapy, and monitoring interval are set based on your labs, your symptoms, and your life.

Everything after that can be telehealth

Once you are established, follow-ups, dose adjustments, and lab reviews can all be handled remotely for patients anywhere in Michigan. Pellet insertions are the exception — those are always in-office.

Honest Limitations

TRT is a long-term commitment with real physiology behind it, and you should understand the tradeoffs before starting.

It is generally lifelong. Stopping without a structured plan usually means symptoms return, often worse, because your own production has been suppressed.
It suppresses fertility. Discuss family planning before you start, not after.
It requires monitoring. Hematocrit, estradiol, and PSA need ongoing attention. Rising hematocrit is the most common reason a dose gets adjusted.
It is not appropriate for everyone. Untreated prostate cancer, untreated severe sleep apnea, uncontrolled heart failure, and certain blood disorders are contraindications.
It will not fix everything. If low testosterone is not what is driving your symptoms, optimizing it will not resolve them — and we will tell you that rather than sell you a year of therapy.

Testosterone is a Schedule III controlled substance. Treatment is prescribed only where clinically indicated, following evaluation and appropriate laboratory confirmation.

Common Questions

How much does TRT cost in Ann Arbor?

$299 per month at Arbour Longevity, and that includes your consultations. Hormone pellet therapy is priced separately at $1,199 per insertion, with each insertion lasting roughly three months and follow-up consults included at no charge. HSA and FSA funds are accepted.

Do I need a referral to start testosterone therapy?

No. You can book directly. Arbour Longevity is a cash-pay practice, so no referral or insurance authorization is required.

Do I have to come in, or can I do this by telehealth?

Your first visit must be in person at our Ann Arbor clinic. After you are established, follow-ups, dose adjustments, and lab reviews can all be done by telehealth anywhere in Michigan. Pellet insertions are always in-office.

How long before I feel a difference?

Most men notice improvements in energy and sleep within two to four weeks. Libido and cognitive changes typically emerge between six and twelve weeks. Body composition changes are the slowest, generally becoming apparent between three and six months. Individual response varies.

What is the difference between injections and pellets?

Injections are self-administered weekly or twice weekly at home, are the easiest to adjust, and are included in the $299 monthly program. Pellets are inserted in-office roughly every three months at $1,199, give the steadiest levels, and require no weekly dosing — but the dose cannot be changed once inserted.

Will TRT affect my ability to have children?

Yes, potentially. Exogenous testosterone suppresses natural production and can significantly reduce sperm count. If you are planning to father children, raise it at your first visit. Fertility-preserving protocols exist, but that decision needs to be made before starting therapy.

Do you accept insurance?

Arbour Longevity is a cash-pay practice. HSA and FSA funds are accepted, and receipts are provided for potential reimbursement. Lab work ordered through LabCorp or Quest may have partial coverage under your plan.

Start With the Labs

Find out what your levels actually are, and whether testosterone is the right answer for how you have been feeling.

Book Your First Visit

Gandhi Bhattarai, FNP-BC, PMHNP-BC · Arbour Longevity
2217 Packard St #15, Ann Arbor, MI 48104 · (734) 436-3357

Reviewed by Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC — triple board certified nurse practitioner

Last updated: August 3, 2026

This page is provided for educational purposes and is not a substitute for individualized medical advice. Whether a treatment is appropriate for you is determined during consultation.

TRT Across Washtenaw County

Testosterone replacement therapy in Ann Arbor, serving men throughout Washtenaw County — Ypsilanti, Saline, Dexter, Chelsea, Milan, Pittsfield Township and Whitmore Lake. Treatment begins with a full panel, not a single total testosterone reading, and the route is matched to how you actually live. If you are looking more broadly, we also have a page on hormone replacement therapy in Ann Arbor.

Hormone Therapy Ann Arbor Testosterone Pellets Ann Arbor Hormone & Adrenal Testing Sermorelin Ann Arbor Male Enhancement Clinic Ann Arbor Longevity Clinic Southeast Michigan

TRT across Washtenaw County

Men travel to our Packard Street clinic from Ann Arbor, Ypsilanti, Saline, Dexter, Chelsea, Milan, Pittsfield Township and Whitmore Lake. Testosterone therapy is not a one-appointment treatment, so being inside the county rather than an hour away is part of what makes it work.

Who is actually prescribing

The men's health clinics that advertise into Ann Arbor are largely franchises, and several operate from outside the county entirely. Here you are seen by Gandhi Bhattarai, FNP-BC, PMHNP-BC — triple board certified, and the owner of the practice. Same clinician at the first visit, the results visit and every review after.

Labs before, and labs during

Full evaluation before anything is prescribed, then ongoing monitoring rather than a standing repeat. Protocols are fertility-aware, and what that means for you is discussed before you start, not after.

The mood and sleep half of it

Low testosterone rarely arrives on its own — sleep, mood, motivation and concentration usually come with it, and in most settings those get sent to a different clinician. The psychiatric mental health certification means both halves are looked at in the same appointment.