Manus Solis
Testosterone Therapy
Physician-prescribed, individually dosed, and measured against outcomes that matter.
Overview
Testosterone therapy (TRT) restores physiological testosterone levels in men with documented deficiency. At Manus Solis, treatment is physician-led and bloodwork-based: comprehensive labs first, individually titrated dosing after, with ongoing monitoring through the Vis Viva Score. Testosterone is prescribed as a daily transdermal cream or a Health Canada-approved gel. Virtual consultations are available across Ontario.
Testosterone governs energy, cognition, body composition, libido, mood, and cardiovascular function. When levels decline, whether from age, illness, or metabolic disruption, the effects are felt across every system. Testosterone replacement therapy restores physiological concentrations under close medical supervision, with dosing guided by bloodwork, symptoms, and functional performance.
At Manus Solis, testosterone therapy is prescribed within a structured clinical framework. We track your Vis Viva Score across three domains: how you feel (Sensus), what your blood reveals (Pulsus), and what your body can do (Virtus). Dosing is titrated to response. We adjust until the numbers, the symptoms, and the performance data converge.
Common Symptoms
- Persistent fatigue
- Reduced muscle mass
- Increased body fat
- Low libido
- Erectile difficulty
- Brain fog or poor concentration
- Depressed mood or irritability
- Disturbed sleep
- Decreased exercise tolerance
What We Measure
- Total testosterone
- Free testosterone
- SHBG
- Estradiol (E2)
- LH & FSH
- PSA
- CBC & hematocrit
- Fasting insulin & glucose
- Lipid panel
- Thyroid panel (TSH, fT3, fT4)
- DHEA-S
- Prolactin
Hormones & Treatments
- Testosterone (transdermal cream or Health Canada-approved gel)
- HCG (testicular function, fertility)
- DHEA
- Thyroid (if concurrent deficiency)
Custom-compounded by our Ontario compounding pharmacy partner Trutina. Individually dosed. Physician-titrated.
Before the first prescription
What we test before prescribing testosterone
Every man completes bloodwork before his first testosterone prescription. The requisition goes out once your intake forms are complete and can be drawn at LifeLabs or Dynacare anywhere in Ontario. It serves two purposes: a baseline to measure change against, and a safety screen for anything that would change the plan.
The panel covers the hormonal picture (total and free testosterone, SHBG, LH and FSH, prolactin, estradiol), the safety markers (PSA, a complete blood count with hematocrit, liver and kidney function) and the metabolic context that decides how well testosterone will work (fasting insulin and glucose, HbA1c, lipids, a full thyroid panel). OHIP-insured tests are billed to OHIP by the laboratory; uninsured tests are billed to you by the laboratory.
The bloodwork is not a gate. A total testosterone in the low-normal range does not disqualify a man with clear symptoms; a reference range describes a population, not a target for you. What the panel does is show where you start and flag what needs attention first: a PSA that needs explaining, a red cell count that is already high, a thyroid or insulin problem that would blunt the benefit of testosterone. Those are addressed before or alongside the prescription, and the panel is repeated at 4 to 6 weeks so the first dose adjustment at Visit 2 is made on data.
Testosterone is prescribed as a transdermal cream or a Health Canada-approved gel, applied once daily. We favour the cream: it is concentrated, so a small volume delivers the dose; it is absorbed steadily through the skin, so levels stay even through the day instead of peaking and falling as they do with injections; and the dose can be moved in small steps at each reassessment. We do not implant pellets and we do not prescribe anastrozole; estradiol is measured, not suppressed by default. Fertility is discussed before the first prescription: HCG can be prescribed alongside testosterone for men who want to protect testicular function, and men planning a pregnancy are referred for fertility assessment first.
Treatment
How We Treat This
We prescribe transdermal testosterone, a compounded cream or a Health Canada-approved gel, individually dosed and adjusted to your response. We do not prescribe anastrozole and we do not implant pellets. Fertility is discussed before the first prescription, with HCG available for men who want to protect testicular function. The first reassessment is at 4–6 weeks; after that, the pace is set by your response.
Men with symptoms consistent with testosterone deficiency, read alongside their bloodwork rather than ruled in or out by a single number. Whether you are newly investigating low T or dissatisfied with a current protocol, we welcome the conversation.
Questions
FAQ
Is testosterone therapy legal in Ontario?
Yes. Testosterone is a regulated medication prescribed by licensed physicians in Ontario for clinically diagnosed hypogonadism and related conditions. At Manus Solis, all prescriptions are written by our physician and dispensed by a licensed Ontario pharmacy: a compounding pharmacy for the cream, or any pharmacy for a Health Canada-approved gel.
How long before I notice results from TRT?
Most men report improved energy and mood within 3-4 weeks. Body composition changes, libido improvement, and cognitive clarity typically become apparent over 8-12 weeks. Full optimization, where lab values, symptoms, and performance metrics are all aligned, often takes 3-6 months of careful titration.
What is a normal testosterone level in Canada?
Canadian laboratories report total testosterone in nmol/L. Ontario laboratories such as LifeLabs use an adult male reference interval of roughly 8.4 to 28.8 nmol/L, and the Canadian Urological Association guideline treats a morning total testosterone below about 10 nmol/L as a reasonable diagnostic threshold while noting that some men have symptoms at higher levels and that the measurement is a complementary tool, not an absolute one. A reference interval describes a population, including men who feel unwell; it is not a target. We read the number with your symptoms, your free testosterone and SHBG, and your metabolic markers.
Will testosterone therapy affect my fertility?
Exogenous testosterone suppresses sperm production through its effect on LH and FSH. We raise this before any prescription is written. HCG can be prescribed alongside testosterone for men who want to protect testicular function, and men planning a pregnancy are referred for fertility assessment first.
What monitoring is required during testosterone therapy?
Bloodwork is drawn before the first prescription and again at 4–6 weeks for Visit 2, when the first dose adjustment is made. Each panel includes total and free testosterone, hematocrit, PSA, estradiol and metabolic markers, and symptom scores and functional performance are reviewed at every visit. After Visit 2, the pace of reassessment is set with you according to your response rather than a fixed calendar.
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 compounding pharmacy partner Trutina.
Begin
Book a Discovery Call
A confidential conversation with our physician and founder.
inquiries@manussolis.ca · Toronto · Yorkville · Forest Hill · Rosedale