Hormone Therapy — Testosterone, BHRT & Pellet Therapy

You Shouldn't Have to Feel Like This

You're exhausted by 2 PM. Your brain feels like it's running through mud. You've lost interest in things you used to enjoy — maybe even in people you love. Your joints ache, your sleep is wrecked, and you can't figure out why you're gaining weight when nothing in your life has changed.

And every doctor you've seen has told you the same thing: your labs are "normal." Maybe they checked a total testosterone or a TSH and said you're fine. Maybe they handed you an antidepressant and sent you on your way.

If you're looking for a hormone doctor near you who actually investigates the root cause instead of just writing prescriptions, that's what we do in Central Texas. You're not crazy. And you're not just getting old.

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Here's What's Actually Going On

Hormones don't just decline with age — they decline for reasons. And those reasons matter.

Here's the thing: most clinics that offer hormone therapy skip the most important step. They check a total testosterone, see that it's low, and start writing prescriptions. That's not medicine. That's a vending machine.

Patients come to our clinic from Temple, Killeen, Georgetown, and throughout Central Texas because we don't work that way.

Before I put anyone on testosterone or any hormone replacement, I need to understand why your levels are where they are. Is it your thyroid dragging everything down? Insulin resistance? Chronic inflammation? Poor sleep tanking your recovery? Stress burning through your cortisol and taking your sex hormones with it?

Hormones sit right at the overlap of what I call the foundation and the deeper layer of health — your metabolic function, your gut, your stress response, and your environment all feed directly into how your body produces and uses hormones. If we don't address those, we're just putting a fresh coat of paint on a crumbling wall.

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What I Actually Test

When you come in for a hormone evaluation, we're not running a basic panel and calling it a day. I'm looking at:

For everyone:

• Total and free testosterone

• Estradiol

• DHEA-S

• Full thyroid panel — TSH, free T3, free T4, reverse T3, thyroid antibodies

• Fasting insulin and HOMA-IR (insulin resistance score)

• Inflammatory markers — CRP, ESR

• CBC, metabolic panel, lipids

• Vitamin D, B12, ferritin

For women specifically:

• Progesterone

• FSH and LH

• Estrogen metabolites when indicated

For men specifically:

• SHBG (sex hormone-binding globulin — tells me how much of your testosterone is actually available)

• PSA

• Hematocrit (testosterone can push red blood cell production — I watch this closely)

The labs tell a story. And when you filter them through your symptoms and your history, you start to see patterns that a single testosterone level would never show you.

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How I Approach Treatment

Once I understand the full picture, we talk options. And I mean actually talk — not hand you a prescription and say good luck.

Pellet Therapy

This is what I use most often, for both men and women. Small hormone pellets — about the size of a grain of rice — get inserted just under the skin, usually in the hip area. Takes about five minutes in the office.

Why I like pellets: They deliver a steady, consistent level of hormone. No peaks and valleys. No remembering to apply a cream every day or give yourself a shot every week. You get them, you forget about them, and your levels stay where we want them.

• Women: Typically every 3 months

• Men: Typically every 4 to 6 months

Creams

Good option for some patients, especially if we're fine-tuning or if someone wants more flexibility with dosing. The downside? You have to apply it daily, absorption varies depending on your skin and where you apply it, and there's a transfer risk — meaning your partner or kids can absorb it through skin contact if you're not careful.

Injections

Some men prefer injections — usually weekly or biweekly. They work, but you get more of a rollercoaster effect. Levels spike after the injection and drop before the next one. Some guys feel that cycle and don't love it. Others don't notice at all.

I'll be perfectly honest with you — there's no single "best" option. It depends on your labs, your lifestyle, and what you're actually willing to do consistently. We figure that out together.

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This Isn't Just for Men

I treat both men and women with hormone therapy, and honestly, women are underserved in this space in a way that drives me crazy.

Perimenopausal women — typically mid-thirties to early fifties — are some of the most dismissed patients in medicine. Fatigue, brain fog, weight gain, mood swings, low libido, sleep disruption. Sound familiar? These women get shuffled between their OB and their PCP, put on birth control or SSRIs, and nobody checks their actual hormone levels.

Testosterone isn't just a "male hormone." Women need it too — for energy, mental clarity, bone density, muscle maintenance, and yes, libido. When it's optimized alongside progesterone and estradiol, the results are significant.

The Breast Cancer Question

I want to address this head-on because it comes up constantly, and it should.

There's a longstanding concern about hormone therapy and breast cancer risk. And I take that seriously — I'm not cavalier about it.

Here's what the data actually shows: bioidentical testosterone, when used appropriately and monitored properly, has not been shown to increase breast cancer risk. Some data actually suggests it may be protective.

I've had patients who are breast cancer survivors — one was on letrozole, which is an estrogen blocker used after certain breast cancers. Her oncologist wasn't thrilled about adding testosterone. I get that. But here's the nuance: her cancer was low-grade, localized, no metastasis. Her quality of life on letrozole alone was terrible. After a thorough risk discussion — informed consent, not hand-waving — we added testosterone. The benefits outweighed the risk for her specific situation.

That's the point. This isn't a one-size-fits-all decision. I don't love stripping someone of all their hormones entirely. Period, end of story. But every patient gets an individualized risk-benefit conversation, not a blanket policy.

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What to Expect

First Visit

Your first visit is a real conversation — usually 45 minutes to an hour. We go through your full history, your symptoms, your goals, and what you've tried before. I order comprehensive labs, and we schedule a follow-up to review everything together.

I don't prescribe hormones on the first visit. I need the full picture first.

Timeline

Most patients start noticing changes within 2 to 4 weeks of starting therapy. Energy and mental clarity tend to improve first. Body composition, libido, and mood often take 2 to 3 months to really dial in.

This is never a straight line. We'll adjust. We'll recheck labs. We'll fine-tune. That's how this works.

Follow-Up

I recheck labs at about 6 weeks after starting, then every 3 to 6 months depending on where we are. Pellet patients come in for reinsertion on a regular schedule, and we use those visits to assess how things are going.

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Pricing

I believe in pricing transparency. Here's what hormone therapy costs at Rooted Health:

Pellet Therapy:

• Women: $100 every 3 months

• Men: $150 every 4–6 months

Membership (required for all patients):

• Adult: $245/month

• Senior (65+): $225/month

Your membership covers your visits, lab reviews, ongoing management, and direct access to me. No copays, no surprise bills, no insurance games. This is Direct Primary Care — you're paying for a relationship with your doctor, not a 7-minute visit with a billing code.

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If Any of This Sounds Familiar

If you've been told your hormones are "normal" but you feel anything but — or if you're getting hormone therapy somewhere else but nobody's actually investigated why your levels were low in the first place — that's exactly the kind of thing we dig into.

This is what I do every day. And I'd rather have the conversation and find out you don't need hormones than watch you suffer because nobody took the time to look.

Call us at 254-780-0023 or book a consultation online.

Rooted Health Clinic — 1401 N Stagecoach Rd, Salado, TX 76571

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Direct Primary Care · No Insurance Required · Membership-Based Practice