Dr. Sam Madeira, NMD
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Low testosterone & men’s health

Low testosterone, TRT & erectile dysfunction

Low energy, low libido and losing your edge aren’t just “getting older.” Dr. Sam Madeira, NMD helps men in Arizona, Montana and Washington find out why testosterone is low and what can be done about it, by telemedicine.

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Telemedicine for adults in Arizona, Montana & Washington

Low testosterone is common, but not normal

Testosterone levels in men have been declining for decades. Aging plays a part, but so do sleep, metabolic health, stress and exposure to endocrine-disrupting chemicals in plastics and other everyday products. Dr. Madeira has discussed these overlooked causes on many podcasts.

Overlooked causes

  • Poor or insufficient sleep
  • Insulin resistance, excess body fat and metabolic syndrome
  • Chronic stress and overtraining
  • Endocrine disruptors and environmental toxins, including heavy metals and mold toxins
  • Thyroid problems, medications and pituitary conditions

How Dr. Madeira approaches low testosterone

  1. Proper testing: repeated morning levels and related hormones to find the cause.
  2. Address root causes with sleep, nutrition, training, stress, and environmental exposure changes, plus personalized nutritional and botanical support.
  3. Discuss hormone therapy when appropriate and permitted under federal rules and your state’s laws, with ongoing safety monitoring.

From The Dr. Madeira Show

Listen and learn more

Frequently asked questions

What causes low testosterone?

Causes include aging, poor sleep, excess body fat and metabolic problems, chronic stress, certain medications, pituitary or testicular conditions, and environmental endocrine disruptors. Several overlooked causes are reversible.

How is low testosterone diagnosed?

Diagnosis is based on symptoms plus repeated early-morning testosterone tests, usually with related hormones such as free testosterone, LH, FSH, SHBG and estradiol, to understand why levels are low.

Is TRT (testosterone replacement therapy) right for me?

TRT can help some men with confirmed low testosterone and symptoms, but it isn’t right for everyone and it has risks and trade-offs, including effects on fertility. Dr. Madeira starts by finding why levels are low, and discusses whether hormone therapy makes sense for you.

Can I get testosterone therapy by telemedicine?

It depends. Testosterone is a federally controlled medication, and whether and how it can be prescribed by telemedicine depends on current federal rules and your state. Dr. Madeira focuses first on finding and addressing root causes, and discusses hormone therapy options when appropriate and permitted.

Can low testosterone be raised naturally?

Sometimes. Improving sleep, body composition, nutrition and stress, reducing endocrine-disruptor exposure, and addressing medical contributors can meaningfully improve levels for some men. Results vary.

Do you help with erectile dysfunction?

Yes. Erectile dysfunction often has hormonal, vascular, metabolic and psychological contributors. It can also be an early sign of cardiovascular disease, which is worth evaluating.

Related: Thyroid · Heavy metals · Who I serve

This page is general education, not medical advice, and does not create a doctor–patient relationship.

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Ready to find out why your levels are low?

Book a free 30-minute discovery call with Dr. Madeira. We’ll talk about your goals, your situation and whether working together is the right fit.

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Telemedicine for adults in Arizona, Montana & Washington.