Eastern DeKalb County runs on early alarms. A lot of Lithonia households have someone working for the county school system or county government, someone on a logistics shift along the I-20 corridor, and someone in health care at Emory Hillandale. Those schedules do not leave much room for a man to sit with the fact that he has been dragging for a year. He assumes it is age, or the overtime, or both, and he keeps going. Fatigue that stubborn deserves a lab panel rather than a guess.
This is also a place with a physical memory. Lithonia grew up around the Tidal Grey granite cut from the outcrops nearby, and the men here still tend to measure themselves by what they can do with their bodies: yard work, a Saturday on the Arabia Mountain PATH Trail, keeping up with grandchildren. When that capacity slips faster than it should, it is worth asking why. Testosterone is one possible answer among several, and a physician evaluation is meant to rule things in or out honestly, not to hand out a prescription to everyone who walks in.
Our single office is at 5009 Roswell Road NE, Suite 201, in Buckhead, so a visit from Lithonia usually means I-20 west to I-285 north around the east side of the Perimeter, then off at Roswell Road. Some men prefer to stay on I-20 to the connector and take GA-400 to the Buckhead exits. Either way, the pattern of care is the same: labs and a medical history first, a conversation with a physician about what the numbers actually mean, and if treatment is appropriate, ongoing monitoring rather than a one-time handoff. Dosing and follow-up are adjusted by your physician over time.
About Testosterone Replacement Therapy
Testosterone replacement therapy treats a medical condition called hypogonadism, in which the testicles do not produce enough testosterone or the brain's signaling to them is impaired. The symptoms are easy to dismiss one at a time: low energy that sleep does not fix, reduced sex drive, difficulty with erections, loss of muscle and strength despite training, added weight around the middle, irritability, low mood, brain fog, and poor recovery. Any one of these has other explanations, which is exactly why testosterone deficiency has to be confirmed with laboratory testing rather than assumed from how a man feels.
Properly prescribed, testosterone therapy is replacement, not enhancement. The goal is to restore a level in the normal physiologic range for an adult man and to relieve symptoms, not to push levels as high as possible. FDA-approved testosterone products are indicated for men with hypogonadism associated with a medical condition affecting the testicles, pituitary, or hypothalamus. Federal labeling still carries a limitation of use stating that safety and efficacy have not been established for low testosterone attributed solely to aging, so a careful workup matters before anyone writes a prescription.
At Atlanta Medical Institute, testosterone therapy is a physician-directed program. A physician reviews your symptoms and history, orders the appropriate blood work, interprets it against your overall health, and decides whether treatment is appropriate for you. If it is, your physician selects the formulation and dose, and you are followed with scheduled lab work so the dose can be adjusted and safety markers can be watched over time. Patients travel to our Atlanta office on Roswell Road from across metro Atlanta and north Georgia for this kind of supervised care.
What testosterone therapy involves
Diagnosis comes first. Testosterone follows a daily rhythm and is highest in the morning, so total testosterone is drawn early in the day, and the diagnosis generally rests on two separate morning measurements rather than a single result. Professional guidelines commonly treat a total testosterone below roughly 300 ng/dL, paired with consistent symptoms, as supporting the diagnosis. Because results vary between laboratories and assays, repeat testing is best done the same way each time.
A useful workup looks beyond the single number. Your physician may add free testosterone and sex hormone binding globulin, LH and FSH to distinguish a testicular cause from a pituitary or hypothalamic one, prolactin, estradiol, a complete blood count to establish a baseline hematocrit, PSA where age-appropriate, plus metabolic, thyroid, and lipid testing. Several reversible causes can lower testosterone on their own, including obesity, untreated sleep apnea, poorly controlled diabetes, thyroid disease, heavy alcohol use, chronic opioid or corticosteroid use, and acute illness. Treating the underlying cause sometimes resolves the problem without hormone therapy at all.
When therapy is appropriate, there is more than one way to deliver it. Your physician will weigh how steady you want your levels, your tolerance for needles, cost and coverage, and household considerations such as young children or a partner who could be exposed to a topical product.
- Intramuscular or subcutaneous injections of testosterone cypionate or enanthate, typically weekly or every other week, often self-administered at home
- Long-acting injectable testosterone undecanoate, given in a clinical setting at longer intervals, which produces steadier levels
- Topical gels and creams applied daily, which require care to avoid transferring testosterone to a partner or child through skin contact
- Transdermal patches worn daily
- Subcutaneous pellets placed in the office that release testosterone over several months
- Oral testosterone undecanoate capsules taken twice daily with food
- Nasal testosterone gel, dosed several times a day
Who is a candidate
A candidate is an adult man with symptoms consistent with testosterone deficiency and laboratory testing that confirms it. Symptoms without low levels, or low levels without symptoms, usually call for more investigation rather than a prescription. Age by itself is not a qualification, and neither is a desire for better gym results.
Some conditions make testosterone therapy unsafe or require it to be deferred until they are evaluated or controlled. Your physician will screen for these before starting and will re-check some of them during treatment.
Fertility deserves a separate conversation. Testosterone therapy suppresses the body's own production of testosterone and sperm, and for men of reproductive age it should be treated as having a contraceptive effect. If you may want children, tell your physician before starting. There are approaches that address low testosterone while protecting sperm production, and sperm banking before treatment is an option worth discussing. Sperm production often recovers after stopping therapy, but recovery can take many months and is not guaranteed.
- Known or suspected breast cancer or prostate cancer
- A prostate nodule or induration, or an elevated PSA, until a urologic evaluation is complete
- An elevated hematocrit at baseline
- Untreated severe obstructive sleep apnea
- Severe lower urinary tract symptoms
- Uncontrolled heart failure, or a heart attack or stroke within the past six months
- A history of blood clots or a known clotting disorder
- Plans to conceive in the near term
What to expect
Different symptoms respond on different timelines, and none of it happens overnight. For many patients, changes in libido and mood begin within the first several weeks. Energy and sense of well-being often follow over the first few months. Changes in body composition, meaning lean mass and fat distribution, develop more gradually over the better part of a year, and only alongside consistent training and nutrition. Erectile function may improve, though erectile dysfunction frequently has vascular, neurologic, medication-related, or psychological contributors that testosterone alone does not address.
Expect dose adjustments. The first prescription is a starting point, not a final answer. Follow-up labs tell your physician whether your level is landing in the target range, and whether the timing of the draw relative to your dose explains how you feel at different points in the cycle. Many men need one or two adjustments in the first year.
Expect side effects to be discussed openly. Common ones include acne and oily skin, fluid retention, breast tenderness or enlargement, shrinkage of the testicles, and an increase in red blood cell concentration. Testosterone can also raise blood pressure and can worsen existing sleep apnea. Most of these are manageable with a dose change, a change in formulation, or additional treatment, and they are a reason to stay in contact with your physician rather than a reason to avoid care.
It is also fair to ask how long you will be on it. Testosterone therapy for confirmed hypogonadism is usually ongoing, because stopping generally returns levels and symptoms to where they were before, and the body's own production takes time to restart. That is part of why the decision to begin deserves a real evaluation.
Safety and monitoring
Supervised testosterone therapy means scheduled laboratory monitoring, not a prescription and a refill. Testosterone level, hematocrit, and symptom response are typically reassessed a few months after starting, again at around a year, and annually thereafter, with blood pressure checked along the way. A rising hematocrit is the most common laboratory problem on therapy. If it climbs too high, your physician may lower the dose, pause treatment, change the delivery method, or refer for phlebotomy.
Prostate monitoring is part of the plan for men in the age range where PSA screening is appropriate. Testosterone therapy is not currently understood to cause prostate cancer, but because it can affect PSA, your physician will establish a baseline and watch both the absolute value and the rate of change, referring to urology when a result warrants it.
Cardiovascular guidance has been clarified in recent years. After a large randomized safety trial, the FDA in 2025 removed the boxed warning about increased risk of major adverse cardiovascular events from testosterone product labeling. At the same time, the FDA added a warning that testosterone products can raise blood pressure, which may increase cardiovascular risk over time. Practically, that means blood pressure is monitored and managed as part of testosterone therapy, and men with existing cardiovascular disease should have that factored into the decision.
One more note on sourcing. There is a wide market of testosterone and testosterone-adjacent products sold with minimal medical oversight, and some are compounded, imported, or simply unregulated. Products prescribed under physician supervision, with documented lab work and follow-up, are a different proposition from anything obtained without an exam. If you are already on testosterone from another source, bring the details with you so your physician can evaluate where you actually stand.
Getting Here from Lithonia
Most patients from Lithonia pick up I-20 at the Evans Mill or Panola Road exits, head west to I-285 north around the east side of the Perimeter, and come off at the Roswell Road exit a short distance from Suite 201 at 5009 Roswell Road NE; some prefer staying on I-20 to the downtown connector and taking GA-400 to the Buckhead exits instead.
5009 Roswell Road NE, Suite 201
Atlanta, GA 30342
We see patients from across Lithonia and nearby areas including Downtown Lithonia Historic District, Fairington, Swift Creek, Rogers Crossing, Klondike.
Testosterone Replacement Therapy in Lithonia — Frequently Asked Questions
Do I need lab work before starting testosterone therapy?
Yes. Eligibility for testosterone replacement is determined by a medical evaluation that includes blood testing and a review of your health history. Symptoms alone are not enough, because fatigue, low drive, and weight gain have several possible causes. If your results and exam point elsewhere, your physician will say so.
Does Atlanta Medical Institute have an office in Lithonia?
No. We have one location, at 5009 Roswell Road NE, Suite 201 in Atlanta, and we serve patients who travel in from Lithonia and the rest of eastern DeKalb County. Most take I-20 west to I-285 north and exit at Roswell Road.
How often would I need to come in from Lithonia once I start?
Testosterone therapy is monitored care, so expect follow-up visits and repeat lab work, more often in the early months and less frequently once things are stable. Your physician will set the schedule based on your results, and we try to group visits so the drive is worth the trip.
How do I know if my testosterone is actually low?
Only blood work can answer that, and it needs to be done correctly. Total testosterone is drawn in the morning, when levels are highest, and the diagnosis generally rests on two separate morning measurements rather than one. A level below roughly 300 ng/dL combined with consistent symptoms supports the diagnosis. Your physician will usually order additional tests, including LH and FSH, free testosterone, a complete blood count, and PSA where appropriate, to identify the cause and to establish safety baselines before any treatment begins.
Will testosterone therapy affect my ability to have children?
Yes, and this is important to raise before you start. Testosterone therapy suppresses the body's own hormone signaling, which reduces sperm production, sometimes to zero. Men of reproductive age should assume it has a contraceptive effect. If you may want children now or later, tell your physician. There are treatment approaches that raise testosterone while preserving sperm production, and banking sperm before starting is an option. Sperm production often recovers after stopping, but it can take many months.
Is testosterone therapy bad for my heart?
The picture has become clearer. After a large randomized cardiovascular safety trial, the FDA in 2025 removed the boxed warning about increased risk of major adverse cardiovascular events from testosterone product labels. The FDA also added a warning that testosterone can raise blood pressure, which matters over the long run. So blood pressure is monitored as part of therapy, and men with existing heart disease, recent heart attack or stroke, uncontrolled heart failure, or a clotting disorder need that weighed carefully by a physician before starting.
Do I have to use injections?
No. Injections are common because they are effective and inexpensive, and many men give them at home, but they are not the only option. Topical gels and creams, transdermal patches, long-acting injections given at longer intervals, subcutaneous pellets, oral capsules taken with food, and nasal gel are all available. Each has trade-offs in dosing frequency, how steady your levels stay, cost, and practical considerations such as avoiding skin transfer to a partner or child. Your physician will help you choose based on your situation rather than a default.
Can testosterone therapy cause prostate cancer?
Current evidence does not show that testosterone therapy causes prostate cancer. It is still not given to men with known or suspected prostate cancer, and it can affect PSA, so prostate monitoring is part of responsible care. Your physician will establish a baseline PSA before treatment where age-appropriate, recheck it during the first year and periodically after, and refer you to urology if the value or its rate of change warrants a closer look.
Can women receive testosterone?
Testosterone is sometimes used at low doses in women as part of broader hormone care, most often for persistent low sexual desire after menopause, but there is no FDA-approved testosterone product for women in the United States, so any such use is off-label. It is a separate clinical conversation from male testosterone replacement, with different dosing, different monitoring, and different goals. If hormone symptoms are your concern, a physician evaluation will start with which hormones are actually involved.
Want the full clinical detail? Read about our Low Testosterone Treatments program.