Low energy, low drive, and strength that’s harder to keep, while routine labs say everything is fine. We test free and total testosterone, estrogen balance, thyroid, and metabolic function before recommending anything, then build testosterone therapy around your results.
The evaluation is the first step for our hormone, weight, and longevity programs. Looking for everyday primary care? Direct Primary Care members enroll online, no evaluation needed.
Fatigue that doesn’t respond to sleep. Strength that’s harder to maintain despite the effort. Brain fog that affects work, focus, and drive. Weight that won’t move no matter what you do. These symptoms are real, and they’re rarely caused by one thing.
Fatigue, brain fog, low drive, and body composition changes can come from testosterone, thyroid dysfunction, metabolic imbalance, or a combination. That’s why we evaluate the full picture before drawing conclusions.
Standard panels check total testosterone. That doesn’t tell you how much is biologically active, how your estrogen balance is affecting symptoms, whether your thyroid is contributing, or how inflammation and insulin resistance are working against you.
Many men are told their levels are “normal” while experiencing every symptom of hormonal decline. Normal by a lab reference range is not the same as optimal for how you function.
The answer is rarely in a single number.
Structured, ongoing, and built around your biology, not a one-size protocol.
Comprehensive intake and lab evaluation to establish a safe, effective TRT starting point.
Testosterone replacement therapy tailored to your symptoms, labs, and goals.
Ongoing follow-up, lab monitoring, and dose refinement to keep you feeling your best.
Care adapts as your body, training, stress levels, and life stage change.
Everyone starts with a new patient evaluation: an unrushed visit, a full review of your results, and a personalized plan recommendation covering hormones, thyroid, metabolism, and any other relevant findings. You leave with clarity, not a follow-up to schedule a follow-up.
Your plan and its cost are reviewed with you before you continue. All care is individualized and provided by a licensed medical provider. Results vary based on individual factors.
Our office is in Midlothian. Patients drive in from Short Pump, Glen Allen, and the West End, downtown Richmond, Chesterfield, Chester, and Powhatan, and from smaller communities across central Virginia that don’t have a men’s health clinic of their own. Once you’re established, follow-ups can be done by video.
Care runs quarterly rather than weekly. Once you’re an established patient, follow-up visits can be done by video. That keeps the schedule manageable from a distance.
Many of our patients arrive already on treatment: from a telehealth-only clinic, a practice that has closed or changed hands, a provider who never adjusted the dose, or a pellet clinic they’ve outgrown. Switching is routine for us, and there is no gap in your care.
We transition patients off pellets regularly. Pellets release hormone gradually, so the best time to make the change is close to when your next insertion would be due. Book your evaluation a few weeks ahead of that date so your new plan is ready when the pellet wears off.
You may not, and that’s the point. Fatigue, brain fog, low drive, and body composition changes can come from testosterone, thyroid dysfunction, metabolic imbalance, or a combination. We evaluate the full picture before drawing conclusions. While many of our male patients benefit from testosterone replacement, we provide a more comprehensive evaluation to target symptoms unresolved by TRT.
The new patient evaluation is $155. The comprehensive lab panel is billed to your insurance by the lab, or $195 self-pay. Ongoing care runs quarterly and starts as low as $160 a month. Your plan and its cost are reviewed with you before you continue.
Testosterone replacement suppresses the body’s natural production of sperm. If fertility preservation is a priority, we discuss options, including alternatives that support hormone optimization without suppressing sperm production. This is part of the evaluation conversation. We also offer sperm testing and banking for patients who have fertility concerns.
Early improvements in energy and mood are often noticed within 3–4 weeks. Full benefits, including body composition, strength, libido, and cognitive clarity, typically develop over 3–6 months as your protocol is optimized. Results vary from person to person.
Care runs quarterly, structured around lab monitoring, dosing adjustments, and proactive check-ins. You’re not left to manage things on your own between visits, and you have direct access to your provider throughout your care. Once you’re an established patient, follow-up visits can be done by video.
Depending on your evaluation and health goals, your plan may include supplement recommendations, thyroid support, metabolic and cardiovascular health support, GLP-1 therapy, peptides for recovery and performance, NAD+ for energy and cognition, erectile dysfunction treatment, or joint and soft tissue support. Interventions are added one at a time as medically appropriate.
We care for patients from Midlothian, Richmond, Chesterfield County, Bon Air, Powhatan, and Chester, and across the greater Richmond area. Visits are in person at our Midlothian office, and by telehealth when it’s clinically appropriate.
Updated September 2026
