Men's bioidentical hormone therapy
You optimize everything else. Now optimize the machine.
The Domain
You train. You perform. You invest in every edge available to you.
The single system that governs energy, cognition, body composition, drive, and recovery, your hormonal axis, is ready to be quantified and optimized.
This is that practice.
What We Optimize
- Testosterone & androgenic function
- Energy & fatigue
- Cognitive clarity & brain fog
- Body composition & weight
- Muscle mass & strength
- Libido & sexual function
- Erectile function
- Sleep quality
- Mood & emotional resilience
- Stress & cortisol management
- Hair preservation & growth
- Skin health & aging
- Bone density
- Joint integrity & recovery
- Metabolic efficiency
- Cardiovascular performance
- Preventive medicine & longevity
Conditions We Treat
- Andropause (male menopause)
- Low testosterone (hypogonadism)
- Metabolic syndrome
- Insulin resistance & type 2 diabetes
- Dyslipidemia
- Non-alcoholic fatty liver disease
- Adrenal dysfunction
- Hypothyroidism & Hashimoto's
- Growth hormone deficiency
- Osteoporosis & osteopenia
- Erectile dysfunction
- Male pattern fatigue
Hormones We Prescribe
- Testosterone
- Estradiol
- DHEA
- Thyroid (Desiccated, T3 & T4)
- Growth Hormone (HGH)
- Melatonin
- GLP-1 Agonists
Custom-compounded by our Ontario compounding pharmacy partner Trutina. Individually dosed. Physician-titrated. Learn more about BHRT.
The Process
How It Works
I Discovery · 15-minute introductory call. We determine fit.
II Assessment · Comprehensive history, symptoms, goals. Advanced labs: total & free testosterone, SHBG, estradiol, PSA, CBC, metabolic panel, thyroid, cortisol, insulin. Well beyond standard panels.
III Protocol · 60-minute consultation. Results reviewed. Vis Viva Score calculated. Individualized protocol prescribed.
IV Continuity · Follow-up labs at 4–6 weeks. Dosing refined. Reassessment paced to your response. Score tracked over time. Direct physician access throughout.
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.
Getting Started
Vis Viva Onboarding
$895
Visit 1 (60 min)
Comprehensive clinical assessment, full Sensus baseline, treatment initiation, Virtus testing plan.
Visit 2 (30 min, at 4–6 weeks)
Pulsus review (bloodwork results), first dose titration, early clinical response assessment.
Included
Custom blood requisition & review of blood analysis
Written prescription (no additional Rx fee)
Custom-compounded prescription & pharmacy concierge
Pickup at any pharmacy or free FedEx shipping Canada-wide via Trutina
Billed Separately
Laboratory costs (uninsured tests billed to you by the lab)
Compounded hormone medications (billed through pharmacy)
Functional testing (VO2 max, DEXA, external referrals)
This is a private medical practice. Consultations are not covered by OHIP.
Lab coverage depends on the test and your clinical indication.
HSA-eligible. METC-eligible.
Annual
Continuity Program
$3,500 / year
Scheduled Consultations & Follow-Ups
Comprehensive assessments, quarterly reviews, and brief check-ins throughout the year.
Prescription Management
Year-round Rx management, pharmacy concierge, refills coordinated.
Blood Analysis
Custom requisitions and physician review at every reassessment.
Vis Viva Score Tracking
Ongoing optimization across Sensus, Pulsus, and Virtus domains.
HSA-eligible. METC-eligible.
Questions
FAQ
What is testosterone replacement therapy (TRT)?
Testosterone replacement therapy is physician-prescribed testosterone for men whose symptoms and bloodwork point to testosterone deficiency. At Manus Solis it is prescribed as a transdermal cream or a Health Canada-approved gel, dosed individually and adjusted to clinical response, with bloodwork before the first prescription and again at 4 to 6 weeks.
How do I know if I have low testosterone?
Persistent fatigue, low libido, erectile difficulty, loss of muscle, more abdominal fat, low mood, brain fog and slow recovery are the usual signs. A morning blood draw (total and free testosterone, SHBG, LH, FSH, prolactin, estradiol, thyroid and metabolic markers) shows where you stand. The diagnosis is clinical: the number is read with the symptoms, not instead of them, and a low-normal result does not rule out treatment in a man with a clear picture.
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.
Do you offer testosterone injections or pellets?
No. We prescribe transdermal testosterone only: a compounded cream, or a Health Canada-approved gel for men who prefer a commercial product, applied once daily. A daily cream gives steady levels without the peaks and troughs of injections, and the dose can be adjusted in small steps; that control is why we favour it. We do not implant pellets.
Will TRT affect my fertility?
Testosterone suppresses LH and FSH and, with them, sperm production. We raise this 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.
How soon will I notice changes on TRT?
Energy, libido and mood often shift within four to six weeks; strength and body composition follow over three to six months. Bloodwork is repeated at 4 to 6 weeks for Visit 2, when the first dose adjustment is made. After that, the pace of reassessment is set with you according to your response rather than to a fixed calendar.
Begin
Book a Discovery Call
A confidential conversation with our physician and founder.
inquiries@manussolis.ca · Toronto · Yorkville · Forest Hill · Rosedale