When it comes to testosterone replacement therapy (TRT), misinformation spreads faster than results.
You’ve probably heard it all — “TRT causes rage,” “You’ll go bald,” “You’ll grow breasts,” or “It’ll wreck your heart.”
Most of that is complete garbage.
The truth is simple:
When done correctly, TRT is one of the safest, most transformative therapies available to men.
At Equivalence Wellness, we take a medically precise, no-BS approach: start slow, monitor closely, and adjust as your body adapts. That’s how we minimize side effects and maximize results.
The Real Problem: Cookie-Cutter Clinics
Most horror stories about side effects don’t come from TRT itself — they come from how it’s prescribed.
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Pellet therapy can create massive hormone spikes and crashes. You’ll feel like Superman for a week, then crash and burn.
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Low-T mills push the same 200 mg weekly dose on every man, no matter his labs or body composition.
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Online clinics skip follow-up labs and call it “convenience.”
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And too many doctors were trained to fear testosterone entirely — writing off low T symptoms as “normal aging.”
We don’t do that.
We don’t chase numbers or cookie-cutter doses.
We treat the person, not the spreadsheet.
So, What Are the Real Side Effects?
1. Erythrocytosis and Polycythemia
TRT can increase red blood cell count (RBC) and hematocrit (HCT) — which in extreme cases can thicken the blood.
This is manageable.
We monitor your CBC at every stage, especially hematocrit.
If it rises above a concerning level (typically >54%), we’ll take proactive steps:
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Encourage hydration
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Recommend therapeutic phlebotomy (a simple blood donation)
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Adjust dosing or frequency
Keep in mind — living at altitude (like Colorado) naturally raises your H&H.
That’s why elite athletes train at altitude: higher red blood cells mean better oxygen delivery and performance.
So we look at the full picture before sounding alarms.
2. Estrogen and Estradiol Management
Every man converts a portion of testosterone into estradiol (E2) — that’s normal and healthy.
But too much conversion can cause symptoms like:
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Water retention
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Mood swings
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Sensitive nipples
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Fatigue or irritability
This is where smart TRT management matters.
We closely monitor:
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Total Testosterone
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Estradiol (E2)
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CBC
Our goal is to keep estradiol below 50 pg/mL.
If it rises, we use simple adjustments — hydration, dose timing, or medications like anastrozole PRN — to bring it back down.
We don’t crush estrogen completely (you need it for heart and joint health); we just balance it.
3. Gynecomastia (Gyno)
Yes, gyno is real, but here’s what most people don’t know:
Gynecomastia happens only when estrogen levels stay high for extended periods — and most men who develop it already carry a genetic predisposition.
By controlling estradiol early and monitoring your levels, we keep that risk extremely low.
If you already have sensitive tissue or a known predisposition, we’ll flag it early and adjust your protocol before it becomes an issue.
4. Mild Acne or Oily Skin
Some men experience mild acne during the adjustment phase — typically when testosterone and estrogen are shifting rapidly.
It’s temporary, dose-related, and manageable with basic skin hygiene or small dosing frequency adjustments.
5. Temporary Suppression of Natural Production
Yes, testosterone therapy suppresses natural production while you’re on it — but it’s reversible.
When we need to come off therapy or protect fertility, we use medications like hCG or enclomiphene to support your natural axis and maintain sperm production.
Why These Issues Are Rare in Our Practice
Because we actually monitor and adjust.
Our approach:
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Start low → titrate slowly
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Check labs regularly (Testosterone, Estradiol, CBC)
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Track symptoms, not just numbers
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Encourage hydration and smart lifestyle habits
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Support fertility with hCG or enclomiphene when needed
That’s how we keep side effects to a minimum — and results consistent.
The Real Risk Is Doing Nothing
Here’s what most men don’t realize:
Leaving low testosterone untreated carries far greater risks than TRT itself.
Low T contributes to:
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Weight gain and insulin resistance
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Anxiety and depression
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Poor sleep and low motivation
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Muscle loss and fatigue
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Cardiovascular disease risk due to inflammation and fat distribution
So while the internet argues about potential TRT side effects, the real danger is living your life stuck at half capacity.
Bottom Line
TRT isn’t dangerous — improper TRT is.
With proper dosing, consistent follow-up labs, and individualized care, side effects are rare, reversible, and completely manageable.
At Equivalence Wellness, we don’t push one-size-fits-all doses or pellets.
We focus on what actually works for your body, your lifestyle, and your long-term goals.
Serving the North Denver Metro Area
We proudly support men across the North Denver region, including:
Commerce City • Northglenn • Thornton • Broomfield • Brighton
and other surrounding North Metro communities.
Whether you’re looking for convenient telehealth appointments, medication shipped to your door, or in-person guidance, we make the process straightforward, private, and customized to your goals.
Get Started — Safely and Confidently
Text or Call: (303) 725-0474
Email: www.equivalencewellness.com
Contact Form: https://equivalencewellness.com/contact
Steve Dillenbeck
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