Manus Solis
Low Testosterone
Accurately diagnosed. Properly treated. Continuously measured.
Overview
Male hypogonadism, clinically low testosterone, affects an estimated 20–40% of men over 45. Symptoms accumulate gradually: fatigue, cognitive decline, loss of muscle mass, increased visceral fat, reduced libido, and depressed mood. Because the onset is slow, many men attribute these changes to aging or stress. A morning blood draw and a thorough clinical history can clarify the diagnosis within days.
At Manus Solis, we evaluate testosterone deficiency with a comprehensive panel that goes well beyond total testosterone. We measure free testosterone, SHBG, estradiol, LH, FSH, prolactin, thyroid function, insulin sensitivity, and inflammatory markers. Your Vis Viva Score captures the full clinical picture: what you report (Sensus), what your blood shows (Pulsus), and what your body can do (Virtus). Treatment decisions follow from data, not assumptions.
Common Symptoms
- Chronic fatigue unrelieved by rest
- Loss of morning erections
- Reduced libido
- Difficulty building or maintaining muscle
- Increased abdominal fat
- Brain fog and poor memory
- Irritability or flat mood
- Poor sleep quality
- Decreased motivation
- Joint stiffness or slow recovery
What We Measure
- Total testosterone (morning draw)
- Free testosterone (calculated or equilibrium dialysis)
- SHBG
- Estradiol (E2)
- LH & FSH
- Prolactin
- PSA
- CBC & hematocrit
- Comprehensive metabolic panel
- Fasting insulin & glucose
- HbA1c
- Thyroid panel (TSH, fT3, fT4)
- Cortisol (AM)
- DHEA-S
Hormones & Treatments
- Testosterone (cypionate, enanthate, cream)
- HCG (maintain testicular function)
- Clomiphene citrate (selective cases)
- Anastrozole (estrogen management)
- DHEA
- Thyroid (if concurrent deficiency)
Custom-compounded by our Ontario pharmacy partner. Individually dosed. Physician-titrated.
Treatment
How We Treat This
Treatment depends on the cause. Primary hypogonadism (testicular) and secondary hypogonadism (pituitary/hypothalamic) require different strategies. We may prescribe testosterone replacement, clomiphene citrate, HCG, or a combination, always with concurrent estrogen management and metabolic optimization. Protocols are reassessed at 4–6 weeks and refined quarterly. We treat the complete physiology: symptoms, bloodwork, and functional performance together.
Men with symptoms suggestive of low testosterone who want a definitive diagnosis and a structured treatment plan. Also appropriate for men already on TRT who feel their current protocol is inadequate or poorly monitored.
Questions
FAQ
What testosterone level is considered low?
Most laboratories define the lower limit of normal between 8.4-12 nmol/L (approximately 250-350 ng/dL), but symptoms can occur well within the 'normal' range, particularly when free testosterone or SHBG are abnormal. We evaluate the full hormonal panel alongside your symptoms and functional status. A total testosterone of 14 nmol/L with elevated SHBG and clear symptoms may warrant treatment just as much as a level of 7.
Can low testosterone cause weight gain?
Yes. Testosterone deficiency promotes visceral fat accumulation and reduces lean muscle mass, which in turn lowers metabolic rate. This creates a cycle: increased body fat converts testosterone to estradiol via aromatase, further suppressing testosterone production. Restoring physiological testosterone levels, combined with appropriate exercise and metabolic support, can reverse this pattern.
How is low testosterone diagnosed?
Diagnosis requires at least two morning blood draws showing low testosterone, combined with consistent symptoms. We go further: measuring free testosterone, SHBG, LH, FSH, estradiol, prolactin, thyroid function, and metabolic markers to identify the underlying cause. The distinction between primary and secondary hypogonadism determines the treatment strategy.
I'm in my 30s. Can I have low testosterone?
Absolutely. While age-related decline is the most common cause, younger men can develop hypogonadism from pituitary dysfunction, medications (particularly opioids and certain antidepressants), obesity, sleep apnea, or prior anabolic steroid use. We see men across all age groups and approach each case on its clinical merits.
Ontario-Wide
Virtual consultations available to patients in Toronto, Mississauga, Brampton, Markham, Vaughan, Richmond Hill, Oakville, Burlington, Hamilton, Ottawa, London, and across Ontario. Bloodwork requisitions and prescriptions managed remotely. Compounds shipped directly from our Ontario pharmacy partner.
Begin
Book a Discovery Call
A confidential conversation with our physician and founder.
inquiries@manussolis.com · Yorkville, Toronto