Frequently Asked Questions

No Limits Medical offers a variety of health services including bio-identical hormone optimization,  sexual wellness, hair loss treatment, anti-aging solutions, wellness solutions and comprehensive diagnostics.

No, you do not need a referral to receive treatment at No Limits Medical. 

No. We only see patients that are located within the United States and only in states that allow telemedicine and in which we have a licensed medical provider. You must physically be present in the state in which your appointment is scheduled for.

Only keep your medications in the refrigerator if the label specifically states that the medication should be kept in the refrigerator. NO TESTOSTERONE should ever go in the refrigerator.

We partner with licensed compounding and pharmacies within the United States. Once we complete your synchronous video medical evaluation, review your history and lab studies and write any appropriate prescriptions (if indicated) the pharmacies will generally take 7-10 days to compound and ship your products. You will receive tracking for your medications as soon as it is available. 

Yes!! All your prescriptions will be prescribed by a board certified provider and will have a prescription label. Be sure that you have the box or container that your medication came in that has your name and the prescription label on it for traveling. You can carry anything necessary to administer these medications (such as syringes). Please do keep in mind though that most airlines have a 3oz maximum for carry on liquids so your liquid medications may be required to be in checked luggage rather than carry on luggage. You do not ever need a "travel letter" for medications. Your prescription label is more than sufficient, 

Our clinic only treats adults over the age of 18. We do not determine fitness for any of our treatments by age alone. Age is certainly a factor when we put a customized health plan together for you. However, we always treat patients based on symptoms, not arbitrary standards. A common error in hormone optimization is to treat numbers. Numbers only tell a small part of the story. We do not treat patients based on numbers, we treat patients based on an overall health evaluation and assessment. Your provider will evaluate your lab work, your symptoms, your goals and your overall medical history prior to suggesting an appropriate treatment plan. All men under the age of 30 go through a medical review process in order to ensure that we, as a team, are treating patients appropriately. But there are many younger men and women that can benefit from a variety of life improving wellness plans that we can assist with. You and your provider will determine the plan that is best for you.

The short answer to this is YES. Testosterone WILL reduce your fertility. Will fertility come back once you stop testosterone? Maybe. We don't recommend testosterone for any patient looking to have children in the future. If you are concerned about protecting fertility, please talk to one of our providers about this before beginning any treatment plan to discuss your options.

Hormone optimization helps us to improve energy, motivation, mental clarity, career performance, life enjoyment, lean muscle mass, sexual health and helps to reduce depression and anxiety associated with aging and hormone depletion. Hormone optimization also helps to reduce diseases of aging such as diabetes, insulin resistance, obesity, cardiovascular disease, cancers and osteoporosis. Hormone optimization isn't just about looking, feeling and performing better, it also helps you to improve longevity and quality of life. Talk to your provider to determine if hormone optimization is a good choice for you.

Yes and no. All hormones work on the same negative feedback loop. That means that when your body senses that your level is low the body works to ramp up production of the necessary hormone. Conversely, when the body senses that you have a good level of a hormone, it slows down production because you don't need anymore production right now. So yes, your body will slow down it's production of testosterone (or any other hormone) if you have a good level of the hormone present in your body. If you take away that exogenous supply of the hormone, your body will kick back in again to start producing. But keep in mind that as we age, ALL of us have a natural decline in hormone production. This is just the way we are genetically wired. So you will only produce hormones at an age appropriate rate based on your genetics, history and age. Everyone's natural production of hormones is different but the one thing we have in common is that all hormone production declines with age. Keep in mind that the whole reason you are likely coming to talk to us is that you are already not producing enough good hormones to help you feel and perform at the level you would like. Taking or not taking exogenous hormones is not going to change that. Talk to your provider to see if hormone supplementation and optimization is right for you.

We always recommend a clean diet, regular exercise, good sleep, cessation of smoking, stress reduction and reducing or eliminating alcohol as overall benefits for wellness. These things will allow your body to function better overall, which improves hormone production. However, this is only a part of the solution and while very beneficial, are not likely to get your levels high enough for you to feel and perform your best and maximize your risk reduction from diseases of aging. The younger you are, the more benefit you will gain from these positive changes but eventually, we all lose hormone production as we age.

Bioidentical refers to the chemical structure of a hormone, not the source. A common misconception is that bioidentical means that a hormone comes from a natural source. This is not necessarily true. Hormones are still made in a laboratory or compounded in a compounding pharmacy. However, if the chemical structure of the hormone is identical to the chemical structure of that same hormone in the human body, then the hormone is bioidentical. If you think that bioidentical hormone optimization might be for you, talk with one of our board-certified providers.

It depends. This depends on your particular situation, medical history, family living situation and goals. Testosterone does come in multiple forms such as injectable, oral and topical. The method that is best for you will be determined by you and your provider.

It depends. This depends on your particular situation, age, desire for fertility, medical history and goals. Enclomiphene does help to protect fertility (testosterone DOES decrease fertility) but depending on your age and situation, this may or may not be a good replacement for you for testosterone therapy. Enclomiphene works by blocking estrogen receptors and therefore encourages the body to make more testosterone. While a great medication, there are considerations around this for each and every patient so this will be a decision made by you and your provider.

At the beginning of starting testosterone, you may have a slight increase in water weight gain. This will generally dissipate over a month or two. This is just your body getting used to having hormones again. If this becomes bothersome, concerning or does not go away, you should make an appointment to speak with your provider. This water weight gain can potentially cause a transient increase in blood pressure but overall, keeping testosterone at good, high, steady levels improves blood pressure and overall cardiovascular health. When patients begin a wellness journey they often start paying attention to various aspects of their health that they did not pay attention to previously. Chances are if you notice increased blood pressure after starting hormone optimization, it was already there before treatment but that you are now paying closer attention to various aspects of your health.

Absolutely not. Testosterone is an essential male (and female!) hormone that promotes healthy lean muscle mass, strong, healthy bones, cardiovascular health, better workout recovery and sexual health. Having good, steady testosterone levels also helps to reduce blood sugar, improve insulin resistance, improve mood and reduce depression and anxiety associated with hormone depletion. Keeping bones and muscles strong is essential for healthy aging. Many providers still believe that hormone therapy is "too risky" and they would rather put you at risk for long term diseases such as diabetes, hypertension, osteoporosis and not worry about how you are feeling or how you are functioning. We simply do not understand this way of thinking. We want to help you look good,  feel good and perform well but we also want to help you mitigate your chances of getting or worsening these serious diseases that impact your health, happiness and activities of daily living. Any provider who tells you that hormone therapy is "too risky" or that "your levels aren't low enough" or that the symptoms that you are experiencing are "just a part of aging - deal with it" clearly does not understand hormones, disease prevention, improvement of symptoms or hormone optimization. We hear this story from almost all of our patients. If you have a provider telling you that testosterone or hormone replacement therapy is dangerous, unfounded or not necessary, you should stop discussing your hormones with this provider and sign up for an appointment with us. These are antiquated thought processes not based on the last 30 years of credible, evidence based research and we would love to help you!

Testosterone does not have a very long half life. That means it leaves your body quickly. We dose daily in order to keep levels good, high and steady. By doing this, you feel and perform better instead of dropping off motivation and energy around day 4 or 5 on weekly dosing. Dosing less than weekly (such as twice a month or monthly) is absolutely useless and you should strongly consider changing to a provider more experienced in hormone optimization. By dosing daily, we find that patients feel better, perform better, have more consistent results and have far fewer adverse effects. You providing will discuss dosing for any treatments in your initial appointment and on an ongoing basis.

Yes. The reason this happens is that your body is preparing to deliver more oxygen, blood and nutrients to your muscles in order to improve lean muscle mass. Elevated red blood cell counts do not cause blood clots. Blood clots are caused by bleeding disorders and/or platelets. People who live at altitude have high red blood cell (RBC) counts so that they have greater oxygen carrying capacity. These people do not have any higher risk of blood clots or strokes than the average population. Does this mean that you will never benefit from donating blood? No. There is only one way (outside of chemotherapy) to reduce RBC count, and that is to donate blood. Generally, this is charitable - but not medically necessary. However, there are instances where your provider may recommend this for you based on your own personal situation. Also, some men just feel better overall if they donate blood periodically. There is nothing wrong with periodically donating blood if you would like to do this, as long as you are a candidate to do so. RBCs tend to increase more dramatically with weekly or less frequent testosterone injections. With daily testosterone injections, this is rarely a concern. For any questions regarding this, or other aspects of your care, you should schedule time to speak with your provider.

It sure does! Everywhere on your body except for your head! Hair loss on the head is primarily genetic, but there are things that can be done to help slow this down. If hair loss is a concern for you (whether you are male or female) discuss options for reducing this risk with your provider so that you will understand the options that are available to you for treatment.

There are a lot of poor quality studies out there used to say that hormones cause cancer. Since these poor quality studies in the 70's and 80's there has been a lot of research actually showing the opposite, that keeping hormone levels good, high and steady actually helps to reduce the risk of cancers. This does not apply to synthetic hormones. There are clear links between synthetic hormones and cancer, particularly estrogen and progesterone. Because of this we only use bioidentical hormones for testosterone, estrogen and progesterone. No cancer risk can be eliminated as cancer is a multi-factor disease. If this is something that concerns you, then you should discuss the options with your provider.

Thyroid hormone is one of those good hormones that most people will benefit from having optimized. Many providers do not understand the benefits of optimizing thyroid hormone, even if you are not diagnosed with hypothyroidism. Good thyroid levels improve energy, metabolism, mood, cold intolerance and just overall help improve the way that you feel. All patients are different and everyone's experience with hormone optimization and medications in general is different. As we age, thyroid production tends to slow down and the conversion of precursor to active thyroid hormone slows as well. Talk with your provider about whether optimizing thyroid hormone is the right choice for you.

Many women can benefit from a variety of treatments for Polycystic Ovary Syndrome (PCOS). PCOS is a traditionally under diagnosed and under treated condition for women. There is a common misconception that this diagnosis is made only when cysts are found on the ovaries. This simply isn't true and in reality many women with PCOS never develop ovarian cysts. PCOS is not a disease defined by cysts (though many providers will erroneously not diagnose this condition due to a lack of cystic ovaries). PCOS is actually a disease of insulin resistance that causes many concerning symptoms for women, up to and including irregular periods, acne, weight gain, facial hair, low libido and potential infertility. We understand how to diagnose and treat PCOS and we would love to help you if you feel that you might be suffering from PCOS. Schedule an appointment with your provider to discuss this.

Absolutely not. Estrogen is a very beneficial hormone at the right time for women. Good estrogen levels maintain skin elasticity, helps prevent cardiovascular disease and is essential for keeping bones strong and preventing fractures. Giving estrogen (more accurately bio-identical estradiol) too early in life or in the incorrect situation can cause many issues for women including acne, bloating, bleeding and severe mood swings. Many other clinics put women on estrogen WAY too early and/or start dosing levels too high causing all kinds of adverse effects. This is one of the reasons that we do not recommend hormone pellet therapy. With pellets the components, concentrations, doses, effects and adverse effects can be very difficult to manage. Additionally, topical estradiol or patches should not be used for hormone replacement as they do not protect women against cardiovascular disease, oral estradiol does. Skin creams containing estradiol for anti-aging are different and this is not a concern at all as this is not for hormone replacement. Unless there is an extenuating circumstance, women should ONLY take bio-idential oral estrogen (estradiol) and progesterone due the risks of cancer associated with synthetic hormones. If your provider has you on any type of synthetic hormone therapy, we recommend that you seek out a provider who is more knowledgeable about hormone optimization. We know how and when to offer estradiol to women so please talk with your provider at No Limits Medical about whether estradiol is right for you.

Absolutely! Almost all women will benefit from taking oral progesterone. Progesterone has many benefits for women and is often referred to as the "feel good" hormone. Progesterone reduces the risk of cancers, improves mood, reduces menstrual bleeding and cramps, treats migraines and promotes quality sleep. Oral progesterone should be taken about an hour prior to bedtime. Sublingual progesterone (generally used for the treatment of migraines) can be taken anytime. There is NO reason to not take progesterone even if you have had a partial or total hysterectomy unless there is some type of rare, extenuating circumstance. Telling women that they do not need progesterone is another long standing myth in the realm of hormone optimization that simply isn't true. We will state again though that only bio-identical progesterone should be used, never synthetic. Talk to your provider if you feel that you might benefit from progesterone or if you feel as though you have received poor guidance from another provider regarding your hormone optimization.

Putting all men on estrogen blockers while on testosterone is an old-school way of doing hormone replacement for men. We understand better now that estrogen is very important for men for muscle building, cardiovascular health, good erectile strength, libido and  prevention of osteoporosis. We DO NOT routinely put men on estrogen blockers because we understand hormone optimization for both men and women. Routinely putting men on testosterone and estrogen blockers is an antiquated and cookie-cutter approach to hormone optimization. Does that mean you will never benefit from an estrogen blocker for a short period of time? No. Based on your own personal medical history, lab work and symptoms, there are times where a short course of this may be appropriate, but this is definitely not common. If this is something that concerns you, talk with your provider for more information.