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  • Is this program managed by a Doctor/MD/Physician or a mid-level/PA/NP?
    Emphatically yes! Our patients meet with Dr. Abdullah, who analyzes lab results and adjusts the treatment plan accordingly. He is a licensed Physician who has an MD degree and an MPH/Master's degree in public health. Please find out more about Dr. A here. When it comes to your hormones, you would want a physician to do the assessment and plan. Physicians go through a minimum of 7 years of schooling and countless clinical hours. They are the most knowledgeable members of the healthcare team when it comes to how the human body functions in terms of health and disease. .
  • Are you accepting new patients?
    Yes.
  • What are your services?
    Men/Women's Bioidentical Hormone Replacement Therapy (BHRT), Testicular Atrophy, and Erectile Dysfunction (ED). ​ Weight Management/Medical Weight Loss: We use Injectables and Orals, as well as novel GLP1 injectables such as Semaglutide (Wegovy ®/Ozempic ®), Trulicity®, Mounjaro®, and others within the same class.
  • What is the advantage of Newport Health & Vitality vs online/virtual "men's health" programs?
    We know the numerous online subscription programs presenting themselves as "men's health" or "TRT." They're everywhere on Instagram (IG). Truthfully, the best way to describe them is faceless, high-price, low-value, low-dose, nurse-managed Testosterone IG mills. The service is ineffective, and patient turnover is high, ensuring quick short-term profit. They are not expecting or interested in long-term relationships with their patients. So, what sets us apart? A real Doctor who is genuinely knowledgeable and passionate about hormonal and metabolic health will evaluate you and your blood work, which means better and safer results. We are a comprehensive Andrology clinic. We don't just prescribe Testosterone; we prescribe all the other agents required for an effective and safe Testosterone Replacement Therapy (TRT) program. The IG mills don't We manage the side effects. The IG mills don't. We manage ED and Testicular atrophy. The IG mills don't. We personalize the dosing so you see results. The IG mills don't because they need a low-dose-fits-all approach as they are large volume-based businesses that need to reduce liability and maximize profits. Our physician evaluates you every time! The mills will have a physician as a medical director. Still, a nurse or physician assistant will be assessing you without meaningful supervision by a qualified physician, even if they tell you otherwise. The physician/medical director usually knows nothing about hormone replacement therapy. The IG mills pay a remote physician a monthly fee to borrow the medical license. We question the accuracy of novel home-based hormonal testing; many virtual mills employ these novel testing methods. Sure, there is the convenience factor, which is extremely important for today's busy man. Still, lab result accuracy is vital to an effective and safe hormone replacement program, especially given that home-based testing is variable in terms of quality control and reliability depending on proper sample collection by the patient. We don't sell snake oil, such as NAD and peptides. The IG mills do! They sell you peptides like Ipamorelin and CJC, promising to increase your natural Growth Hormone production, which is false. These "peptides" are fake and don't work even if they are real; their source is undisclosed, and the practitioners and medical directors themselves would never be on them. But they still sell them at a high price to people. All the hormones we prescribe are manufactured by CGMP-compliant facilities. Very often, one cannot verify the source of the meds the IG mills prescribe as they brand them or give you an prefilled syringe. Do you know what's in the syringe? For convenience, you can use our mobile phlebotomy service, get your blood drawn at home or the workplace, and then review lab results with Dr. Abdullah via telephone. When you consider the details of what we offer and our prices, it becomes evident that ours is a value proposition.
  • Anabolic steroids such as Testosterone are readily available on the black market, and they are very cheap. Why should I get them prescribed through your clinic and pharmacies, where it costs much more?
    Just because someone looks great on social media and has 10 million followers, it does not mean they are telling you the truth about what they’re on and how high their dose is. You cannot ascertain that they are on the same stuff that they are stirring you to. Also, if they are hugely muscular and look like the Incredible Hulk, you can rest assured that they are on large doses of Human Growth Hormone (HGH), but they won’t tell you that. They’re not going to give you their secret sauce recipe, and they won’t stir you to their HGH dealer because there’s a tiny amount of black market HGH to go around. On that note, please don’t buy HGH—or HCG, for that matter--from the black market or Mexico. It’s all fake! Indeed, finding a dealer through your friend, personal trainer, or some bodybuilder on social media is relatively easy. But.... You need to know what you are getting. How do you know if the “Deca” is Nandrolone? How do you know if the “Test” you are getting is Testosterone? And how will you find a way to test them for purity? Very often, when we draw labs on patients who admit that they procured their anabolic steroids from the black market, stacking upwards of 800 mg weekly and up, we find lab results consistent with someone who is not on an anabolic or a minimal dose, despite reporting injecting large amounts of whatever they procured. Pharmaceutical-grade Testosterone is safe, effective, and affordable. So why spend money on substances of questionable quality, purity, sterility, and concentration? You end up paying more and getting less.
  • You only prescribe Testosterone, and I want something more anabolic, such as Trenbolone or Boldenone/Equipoise; I also want an oral anabolic, such as Anavar (Oxandrolone). I like substantial doses because I want to get big. I don’t think I can get meaningful gains with the smaller amounts or type of anabolic that a doctor prescribes.
    We prescribe either Testosterone or Nandrolone. They are both bioidentical because they are the same hormones your body makes; this guarantees safety. Trenbolone and Boldenone/Equipoise are popular because they are more anabolic than Testosterone. Still, they are not bioidentical and intended for animals to get them big for sport (horses) or slaughter (cattle). Their cardiac safety profile remains unknown. Trenbolone is more anabolic than Testosterone, but it has unique effects on the brain that may be permanent even after you stop using it. These effects are low libido, sexual dysfunction, drug-resistant ED, and personality changes that can affect your relationships. Is it worth it? Boldenone increases blood thickness and the likelihood of chronic kidney disease more than any anabolic steroid. It also causes permanent intestinal damage in some men. And it's not even more anabolic than Testosterone, so why bother with it? The same applies to dose strength; dosing anabolic steroids beyond a particular weekly amount confers no additional anabolic gains, as the muscle will have reached its genetically determined anabolic potential. Higher amounts would only increase the adverse effects, such as heart muscle remodeling and possibly heart failure. They will convince you that you need to "stack" more. Please don't believe it! You'll get more veins, more acne, more mood swings, accelerated skin aging, and, most importantly, a higher probability of developing ventricular fibrillation or a blood clot before you turn 65. Is it worth it? I don't judge men who decide to live life on the fast lane. Man has a right to self-determination and to choose a certain quality of life. But it must be understood that when you decide to use large doses of veterinary steroids, you are indeed choosing that life. In terms of oral anabolic steroids such as Anavar (Oxandrolone) or Winstrol (stanozolol), these come in small doses and have short half-lives and hence must be dosed frequently throughout the day. They are suitable for certain women because they require much less Testosterone than men. They are also excellent for people on chemotherapy for cancer to help them with their appetite and to counterbalance the catabolic state they're in from both the cancer and the chemo; in these scenarios, they are used short-term. Their long-term safety has not been evaluated. If men take them for HRT purposes, they'll take larger doses that are toxic to the liver; more importantly, why take an oral anabolic when you are already on an injectable? If the injectable amount is insufficient, we will safely increase the dose; remember, more anabolism means more heart remodeling and not necessarily a more admirable body!
  • I don’t want steroids please. I heard they are bad for you.
    Please understand that all anabolic agents are actual “steroids,” including the ones made by your testicles, such as Testosterone. Testosterone is safe if it’s dosed appropriately and monitored by a qualified physician. The stories you hear about “roid rage” and massive heart attacks among young men involve the use of extremely high doses, and usually veterinary steroids such as Trenbolone and Equipoise. These anabolic steroids are artificial and marketed for the sole purpose of maximizing the animal’s growth and strength with disregard for the animal’s lifespan.
  • Does Human Chorionic Gonadotropin (HCG) even work? I know men who tried it, and they said it did not work.
    HCG is not an essential component of HRT unless a man on HRT is trying to conceive. Many HRT patients get on it to preserve testicular volume for cosmetic purposes. It does work for that purpose, but one needs authentic, unexpired, and adequate strength and frequency, as determined by a qualified physician.
  • Can I get my Human Chorionic Gonadotropin (HCG) from Mexico, my dealer, through one of the many TRT clinics or an HCG Diet clinic?
    As of June 2021, the US government began reinforcing the March 2020 rule that HCG is a biological medication, and as such, a pharmacy cannot compound it and hence must be originating from the brand name manufacturer via an electronic controlled substance prescription from a qualified physician, and the medication must be either picked up in person from the pharmacy or shipped from the pharmacy to the patient’s home. Currently, the commercially available brand is Pregnyl®. Any HCG you get from a dealer, Mexico, virtual or high volume TRT mill, or an “HCG Diet” clinic is fake. Some clinics might have residual inventory from bulk HCG obtained from compounding pharmacies before June 2021, but rest assured that it’s expired and not worth your money.
  • Why should I get Erectile Dysfunction (ED) meds like generic Viagra and generic Cialis prescribed by you when I could subscribe to one of the various online websites that offer this type of medication?
    We know the numerous online subscription programs functioning as "men's health" or "ED" mills. Please note: These services often underdose and overcharge to reduce liability and maximize profits. They use lower-quality generics to maximize profits. You need to find out if the medication has expired. Due to quality issues and ensuring that medications are not expired, we reserve the right to determine the pharmacy we associate with; we also dispense these medications at the office in the manufacturer's original bottle with the original insert and the expiration date. We include the manufacturer's original insert because it contains all the instructions for proper use for your convenience and safety. What's the "insert"? It is a physical paper pamphlet with a complete description of the medication, its use, side effects, and drug-drug interactions. It ensures that you get the maximum effect of the drug while minimizing risk. We can make that available to you when we dispense the medication at the office. If you purchase the medicine through our website, please go through the description section to get all the relevant information included in the original insert.
  • I am already getting gear from the black market through a buddy or personal trainer; I am jacked and glorious. What can you do for me?
    Let’s set up a consultation! I hope to persuade you that we may get the same results with lower doses but higher quality pharmaceutical-grade bioidentical hormones. Even if I cannot persuade you to join our vitality program, we can aim for maximal harm reduction. I know you’re getting your labs checked on your own, and you’re getting your blood dumped every few months, and your blood pressure is good. However, there are other adverse effects to monitor and affordable harm reduction tools at our disposal, such as a cardiac echocardiogram and the molecular age-reversal drug Rapamycin.
  • I heard that steroids cause Acne. I don’t want that.
    Acne is a side effect of anabolic steroids such as Testosterone. However, it occurs with higher doses, and it is almost always mild and treatable with moisturizers, antibiotic lotions, and sometimes oral antibiotics such as minocycline. The severe cases of acne you see on the face and back of some guys are because of veterinary steroids such as “Tren.”
  • I heard that Testosterone causes prostate cancer. I don’t want that.
    Testosterone DOES NOT CAUSE new prostate cancer. If it did, we would see lots of it among young men, as they have high levels of Testosterone. Testosterone, however, aggravates pre-existing/undiagnosed prostate cancer, which is why we screen everyone with a PSA before initiating HRT and we screen frequently during HRT. Prostate cancer is the most common cancer in men, and its incidence increases with age. Luckily, we screen for it frequently, and it’s one of the slowest-growing tumors in the world. Also of note, HRT is safe in men who have had their prostate removed from a prior diagnosis of prostate cancer.
  • I don’t want to get too big. I want to be fit. I am afraid Testosterone is going to make me huge, and I don’t want that.
    Let us be clear: We have not had a single patient or heard of anyone complaining of getting “too big.” On the contrary, guys are always trying to lose fat and gain lean mass. Getting “too big” requires years of impeccable diet and exercise discipline, as well as large doses of anabolic steroids. I assure you that that will be the least of your concerns.
  • I heard that HRT causes testicular shrinkage and affects fertility; this does not sound good.
    In terms of testicular atrophy, 90% of men on HRT--regardless of dose--will experience testicular shrinkage; most of the time, it’s about 20% of the pre-HRT testicular volume. But yes, sometimes it’s as much as 50%. It is a subjective and cosmetic issue, not a medical issue--unless you are trying to conceive. Still, if it becomes a source of mental distress or discomfort during erections, or if you are trying to conceive, we could prevent or reverse testicular atrophy with Human Chorionic Gonadotropin (HCG) therapy. Often, men don’t believe in HCG, but that’s because it was not dosed appropriately by their former prescriber, or it was fake or expired.
  • I am already 60 years old. Too late for any of this.
    It’s not about your chronological age! So, what if you are 60 or 80 years old? Does that mean hormones don’t work on you? Does that mean you cannot be coached? Does that mean you should not seek a better quality of life? Does that mean you should be frail? Some men start TRT at 80 years old. Some men are 100 years old and still on 100 mg of Testosterone Cypionate weekly.
  • I am interested in hormone pellets because it is more convenient for me to just “set it and forget it,” and I don’t like the idea of self-injecting.
    Dr. Abdullah does not recommend hormone pellets for the following reasons: If your PSA comes back high and we need to rule out prostate cancer, we want you off Testosterone ASAP, which is easier if you are on an injectable or topical. If you're on pellets, will we wait a few more months until the pellet is metabolized? Are you going to find an available appointment ASAP to get the pellets out, and how will they find them if you've had them for a few months and they're buried somewhere in your subcutaneous fat? Pellets generally do not deliver a dose effective enough to experience desirable results, so you're paying lots of money for very little Testosterone. Changing dose is more complicated with pellets, and you have to wait months before you do so; with injectable TRT, men become proficient at self-dosing with time and can quickly change dosing by consulting with their physician by phone, text, or email. You cannot do that with pellets. Ironically, many men on pellets end up having to supplement with oral or injectable Testosterone, which increases their costs and defeats the whole convenience purpose of pellets. Extrusion: The pellet spontaneously exits from the implantation site, which happens in about 10% of cases; remember that this is painful, and you would have to get another procedure and reinsert pellets and pay more money. It will also increase the likelihood of cosmetic deformity and scarring in the area. You NEVER want a "set it and forget it" kind of situation with hormones! As far as self-injecting, we will coach you until you become comfortable with it. I have never had a patient who agreed to train and did not become proficient at self-injecting. Give us a chance, and we will teach you well.
  • I heard that Testosterone causes “roid rage,” and I don’t want to get fired from my job.
    Testosterone, as well as all anabolic steroids, exert an effect on the brain. They cause a feeling of vigor, masculinity, confidence, Joi de vivre, libido, and youthfulness. But there are two situations when anabolic steroids, including Testosterone, may cause "roid rage," extreme irritability, extreme mood swings, and, you know….make you act very douchy! You have classic bipolar type 1 or schizophrenia, and you did not inform your doctor that you have these conditions or that you are on mood stabilizers such as lithium. You are using constantly high doses of an anabolic steroid. I do not prescribe Testosterone to patients with certain psychiatric conditions or on certain psychiatric drugs. I also do not prescribe large doses of anabolic steroids, and I hope I can convince you that you don't need these large doses.
  • If I would need to take a pill to control my Estrogen level and another hormone to preserve my testicular size and must do labs every so often, wouldn't that be too difficult of a program to adhere to? It just sounds like a lot of work.
    Yes, and it’s worth it and then some! Just ask the men on it if you don’t believe me.
  • I heard that “steroids” can cause heart attacks, strokes, and high blood pressure. I don’t want any of that.
    Please go ahead and read my section on anabolic steroids and the heart.
  • How can I increase my testosterone levels "naturally"? I heard there are supplements you can take to improve your "natural" hormone production.
    Fake news! You will often see the word "boost" or "booster" on these products. These are all marketing terms, and there is no such thing as a "boost" or "booster" in medicine. None of these supplements work. NONE! But they do give you IBS, and they probably have carcinogens in them since they are not regulated by the FDA the way pharmaceutical drugs are. It's all false advertising. If your testicles are making less Testosterone, then the only way to replace that is by taking exogenous Testosterone.
  • I heard that once you start taking Testosterone, you can’t stop! Is this true?
    Fake news! Of course, you can stop. It's not meth or heroin. Generally, guys don't stop because it makes them healthier, sexier, and happier, not because they can't. Now, if a man wants to stop Testosterone if he wishes to conceive or for another reason, then all he needs to do is discuss a quit date with the physician and get on HCG so that there is ample time for pre-HRT testicular function to return by the designated quit date.
  • Do you prescribe Gonadorelin?
    The interest in Gonadorelin stems from the desire to reverse TRT-related testicular atrophy, especially since HCG has become a brand medicine, which tripled its price, causing rationing, underdosing, and less satisfactory results. However, Gonadorelin is currently not available in the US. It requires a special pump apparatus to be administered in a pulsatile fashion. It's also costlier and less effective than HCG. Therefore, we believe that "Gonadorelin" prescribed/sold at so-called "anti-aging" and "men's health" clinics is not authentic and ineffective. If you are getting care through a clinic that prescribes it, you can verify the authenticity by measuring LH levels before and after taking the Gonadorelin. You will then discover for yourself that it is fake. But what if you traveled to another country and got yourself real Gonadorelin? Well it wont work either! Gonadorelin works by stimulating the pituitary gland to release a hormone called LH, which then makes your testicles bigger. However, this effect is offset by the presence of Testosterone and Estradiol in your brain, both of which coming from your Testosterone injections. So in a man who is not taking Testosterone, Gonadorelin may increase the volume of the testicle. But if you are taking Testosterone, then Gonadorelin won't work even if you procured an authentic Gonadorelin product. We hope the FDA will reverse its decision regarding HCG so that it becomes an affordable generic medicine as it used to be. Until then, we are prescribing Pregnyl (brand HCG).
  • Testosterone is supposed to improve erectile function. How come all these huge bodybuilders can’t get it up, and they now have to inject Tri-Mix to treat erectile dysfunction (ED)?
    Assuming that recreational drugs and prescribed psychiatric medications are not involved, there are three reasons behind erectile dysfunction (ED) in a man with adequate libido and who is on high doses of anabolic steroids. Non-bioidentical anabolic steroid use: The direct effect of these hormones on the penile erectile tissue is unknown. High estrogen levels: Estrogen in a man is poorly studied and has a complex interaction with both Testosterone and Testosterone-responsive tissues, such as the corpora cavernosa of the penis. High levels cause erectile dysfunction, but there is evidence that low levels may also cause it. Therefore, estrogen must be regularly monitored and stabilized by adjusting the aromatase inhibitor dose. Nandrolone (AKA "Deca"): The exact association between nandrolone and ED is poorly understood. It may cause changes in the lining of the blood vessels of the penis, which can reduce blood flow, causing ED. Nandrolone may also bind penile alpha estrogen receptors, which can also cause ED. If Nandrolone is used alone without Testosterone, estrogen levels may fall below physiologic levels, which may lead to reduced libido, which then contributes to ED.
  • Why do some younger men who are under the age of 35 have low Testosterone levels and symptoms of low testosterone?
    Endogenous Testosterone production begins to decline at the age of 35. Indeed, we see men in their 20s with low Testosterone levels. Brain tumors, Brain trauma, Diabetes, HIV, Obesity, using anabolic steroids at a very young age, and HIV drugs all cause low Testosterone, either by affecting the pituitary gland or the testicle itself. Even intense psychological trauma can cause testicular failure.
  • I am looking for peptides such as Sermorelin, Tesamorelin, Ipamorelin, CJC, and BPC.
    We don't sell snake oil, such as "peptides," NAD, and Glutathione. Peptides like Ipamorelin, Sermorelin, CJC, and all the others promise to increase your "natural" Growth Hormone production or accelerate recovery from sport-related injury, which is utterly false and unproven. If these "peptides" are effective, why aren't pharmaceutical companies making and selling them? Why can't you get a legitimate, reputable physician to prescribe them? If they are genuine and legitimate, why can't you tell who the manufacturer is? Grab your Ipamorelin bottle and look for the name of the manufacturer. I bet you won't find it. You may find the name of a dispensing pharmacy. But you won't find the manufacturer. Peptides and proteins must be refrigerated to remain stable, so how are these "anti-aging" clinics storing them at room temperature? Why are legitimate peptides like Ozempic, HGH, and Human Chorionic Gonadotropins stored and shipped in cold boxes, yet the "anti-aging" peptides you get from the local clinic are at room temperature?! Why are the nurse practitioners, physician assistants, and medical directors of these "clinics" themselves NOT on the peptides they are selling you? If they are that good and safe, should they not be on them as well?! Aren't they practicing what they're preaching?! Go ahead and request a meeting with the medical director. These "anti-aging" clinics tell you the medical director is available upon request. I bet you won't be able to meet them, and if you do, you will know within 5 minutes of the conversation that the peptides are indeed fake. ANY "clinic" selling these peptides is not only engaging in false advertising, fraud, and click baiting but also blatantly committing harm by injecting into your body substances of unknown origin or efficacy. This should also call into question the legitimacy of all their other services. Please remember that false advertising is reportable to the state medical board. Tesamorelin (Growth hormone-releasing hormone) is often marketed as a "peptide ."But it is a patented protein that is available commercially as EGRIFTA SV®, which costs even more than Human Growth Hormone, so obviously, ANY "clinic" mentioning it on their website or social media account is not only engaging in false advertising. They do not have real Tesamorelin. Ask to speak to the "medical director" about the source of the Tesamorelin. Unlike Ipamorelin, Sermorelin is the generic name of a legitimate peptide drug called "Geref®" that was manufactured by EMD Serono, which is a world-class pharmaceutical company; clinical trials back then showed that Sermorelin/Geref® increases IGF levels--which is also how Human Growth Hormone (HGH) works. However, the manufacturer took it off the market within two years, citing higher costs of production and the inability of the drug to compete with HGH; this makes sense since the original manufacturer's recommended dose of Sermorelin was 2 mg nightly, whereas the dose of HGH is usually around 0.5 mg for the same effect! Now ask yourself, how is a world-class pharmaceutical company (EMD Serono) no longer producing a drug due to high costs and lower efficacy than HGH? Yet, you can purchase it from some random "anti-aging" clinic nearby?! Also, if the original manufacturer (EMD Serono) dosed the drug at 2 mg nightly, how are the "anti-aging" clinics dosing it at 0.25-0.5 mg nightly?! So not only is the drug fake but so is the dosing!
  • I asked my trainer and buddy, who are both very muscular, and I also follow this muscle guy on social media. They all say they’re not on anything and are very disciplined in their diet and exercise! I asked them specifically if they were on Testosterone, and they all said no! Is that possible?
    To get muscular, you need to work out like a spartan, eat like a Viking, and sleep like a king, but yeah, you also need to be on Testosterone, so they’re lying to you. And if they tell you the truth, don’t ask them about their dose because they will lie. Remember, society is still ignorant and judgmental about anabolic steroids, and the government considers the elective use of anabolic steroids to be illegal. They’re getting their steroids from the black market. For all these reasons, men generally lie about their use of steroids and about the amount they are using.
  • Should I get on Testosterone even if I am 25?
    If you have the symptoms, your levels are low, and you don’t have a contraindication, then yes. If your levels are optimal, you have no symptoms, and you want to use super high doses to get super jacked. You may permanently disrupt your Hypothalamic-Hypophysial-Gonadal axis and develop permanent testicular shrinkage and permanent reliance on exogenous Testosterone. Most importantly, when guys start high doses of anabolic steroids that young, the heart will suffer from more cumulative severe damage at the genetic level, which could lead to early death. Remember, you want to look good, feel good, and live long, not die young.
  • I want Human Growth Hormone (HGH)
    Human Growth Hormone (HGH) Therapy: Growth Hormone Therapy benefits a subset of patients when prescribed and clinically and biochemically monitored by a qualified physician. The FDA has approved certain brands of recombinant Human Growth Hormone for treating Adult Growth Hormone Deficiency, which is diagnosed by clinical and laboratory findings. Important to note: Even with a diagnosis of Adult growth hormone deficiency that is verified both clinically and biochemically through a blood test, we do not prescribe HGH without achieving the full potential of anabolic steroids/Testosterone. "Peptides" such as Ipamorelin, Sermorelin, and CJC are being peddled as a cheaper, safer alternative to HGH. These are blatant lies. Peptides are not effective at mimicking either GHRH or HGH. Save your money, and don't fall for that Cool Aid! HGH therapy (when indicated) has an added cost to the price of the visit ($100) and the labs ($100)--in addition to the cost of the medication itself ($500 and up/mo).
  • Why don't you offer pellets?
    Although we understand the appeal of "set it and forget it," we vehemently recommend AGAINST hormonal pellets for men or women for two main reasons. Hormone replacement therapy (HRT) is never a "set it and forget" treatment plan. With time, our bodies change, our needs change, and our hormone receptor density changes. Therefore, it is imperative to use HRT routes that permit timely dose adjustment, which is not possible with pellets. On pellets, people seem to be either underdosed or overdosed. More importantly, the incidence of prostate cancer is high in men, and it increases with age, regardless of hormonal status. Testosterone does not cause prostate cancer. We don't know the cause of prostate cancer. However, should prostate cancer be diagnosed while a man is on HRT, we have to be able to stop HRT as soon as possible; so if you have pellets, how are they going to locate each one of these pellets and remove them timely?
  • Do you prescribe Enclomiphene "clomid" as an alternative to Testosterone replacement therapy (TRT)?
    Enclomiphene is an oral medication that works with the brain; it is considered a selective estrogen receptor modulator (SERM). In the context of its novel repurposing as a TRT alternative, it tells the brain to stimulate the testicle. The brain stimulates the testicle to work harder, and when the testicle works harder, it makes more Testosterone. Enclomiphene may increase total Testosterone levels by 200-800 ng/dl, depending on the dose, age, and baseline gonadal status. In many men, this increase is satisfactory. Since Enclomiphene does not cause the same peak plasma Testosterone elevations as injectable Testosterone, it is less likely to cause erythrocytosis that is high enough to merit regular phlebotomy. Counter to popular belief, estrogen still needs to be monitored and controlled during Enclomiphene therapy. Still, it's easy to understand the appeal of Enclomiphene when compared to exogenous Testosterone. It's a pill, so it's easy to take; it's generic, so it's affordable; it's less likely to require therapeutic phlebotomy; and perhaps most importantly, it does not shrink the testicle the way exogenous Testosterone does, which is by far the most undesirable effect of TRT. Whatever happened to the old adage, "If it's too good to be true, then it's too good to be true?" Enclomiphene reduces IGF levels! IGF is the messenger protein of Human Growth Hormone (HGH); therefore, IGF plasma level should be considered a surrogate for HGH activity for practical purposes. HGH is AKA the "fountain of youth" for good reasons: It maintains and builds bone, muscle, and skin. It is also the most potent hormone for burning mid-section fat. Optimizing IGF levels is associated with remarkable metabolic and cosmetic benefits and a 5-10-year reversal of skin aging. This is not an implication that people should go on HGH to improve their skin. However, it is beneficial to avoid factors that decrease IGF levels; decreasing IGF levels also counters the desirable anabolic effects of Testosterone, as these effects are partly IGF-mediated. The degree to which it reduces IGF is still being determined because, so far, the research was done on men with basal IGF levels under 100 ng/ml; most men start HRT in their 30s, and their IGF is usually over 150 ng/ml. This effect does not appear to be dose-dependent. We measure IGF levels before and after starting Enclomiphene. Also, as a SERM, Enclomiphene is an estrogen antagonist in the bone, which means that long-term use reduces bone mineral density, which is unacceptable. So what's the verdict? Take it or leave it? The short-term use of Enclomiphene is relatively safe and effective at partially reversing androgen-induced testicular atrophy. Its long-term use for the treatment of hypogonadism "low T" also appears to be a relatively safe and effective option. However, the risks of reducing bone mineral density coupled with a reduction in growth hormone outweigh the benefits, and this must be explained to the patient before considering is as an alternative for TRT.
  • If I need to dump some blood (therapeutic phlebotomy), is Dr. Abdullah going to help me with this?
    Yes, we understand that in some cases, we may recommend therapeutic phlebotomy at a particular frequency. Dr. Abdullah will help and direct you through the proper channels.
  • My prolactin levels are always higher than normal. I heard that it could be a cause of my low endogenous sex hormone production; I also heard that sex hormones themselves increase it. Do you treat that?
    The upper limit of prolactin for men is 20 ng/ml. The upper limit of prolactin for women is 30 ng/ml. The concern of elevated prolactin is that it may be from a benign tumor in the brain that is overproducing prolactin and exerting pressure injury to nearby structures of the brain. Additionally, prolactin levels at a certain point may reduce the endogenous production of sex hormones or cause gynecomastia and nipple discharge. A large tumor, even if benign, may cause headaches and visual disturbances, at which point we'd refer for surgical removal of the tumor. If the tumor is large, prolactin levels are usually over 200 ng/ml. If the tumor is small, levels are below 200 ng/ml. Small tumors are treated medically and monitored by serial prolactin measurements. Most of them don't change over time or regress. It's quite rare to detect symptoms and signs of hypogonadism or chest symptoms, such as nipple discharge when prolactin levels are under 50 ng/ml. However, the vast majority of the time, prolactin elevation is not from a tumor. It's idiopathic, which means that the cause is unknown, and it's clinically insignificant and does not warrant any treatment; idiopathic hyperprolactinemia may increase levels up to 100 ng/ml. Alternatively, it's from an identifiable cause, such as elevated estradiol levels, stress, and certain psychoactive medications. For instance, in both men and women, supraphsiologic levels of estradiol may increase prolactin. We see that in women who are pregnant with circulating estradiol levels in the 100s or 1000 pg/ml. We see it in men who are on TRT but not controlling their estradiol levels. We also see it in transwomen. Also, remember that stress alone—due to increased cortisol (stress hormone) production—may increase prolactin by 20 ng/ml on top of normal levels. It's not uncommon to see levels in the 40s ng/ml in patients undergoing a stressful period in their lives. Nipple stimulation also increases prolactin. Moreover, commonly prescribed psychiatric medications such as Prozac and Lexapro can very well increase prolactin to up to 100 ng/ml at the usual dose of these medications. That's why I always try to guide my patients through a "weaning" process to get off of these psychiatric medications. Antipsychotics like risperidone may increase levels to 300 ng/ml. Our lab panel includes prolactin, so rest assured that we would not miss a tumor.
  • Should I try Ashwagandha?
    Please don't. Ashwagandha is one of the newer scams on social media. This stuff grows in parts of India, Africa, and the Middle East; men in these regions are not necessarily in optimal health. I would take any "Eastern" medicine or herb with a generous helping of salt. This plant supposedly increases testosterone levels and reduces stress. Well, it does neither. But it does affect the metabolism and hence therapeutic efficacy of legitimate drugs that your doctor is prescribing to you, so it's harmful. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 1990s. These supplements also contain irritants that can affect your intestine's ability to absorb nutrients and cause irritable bowel syndrome. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by laboratory methods.
  • Should I take Tongkat Ali?
    Tongkat Ali--AKA Longjack--is a plant root extract used in Eastern medicine, specifically in Malaysia. Only a little research has been done on humans; the long-term effects are unknown. Still, from the few human trials, this root extract has been identified as a peptide of 32 amino acids that improves sexual function, decreases stress, increases free testosterone, and decreases cortisol (the primary stress hormone); the mechanism by which it does this remains unknown. The required daily dose of the extract is 200-400 mg. But here is why you should not purchase Tongkat Ali. A patent has been issued jointly to the Government of Malaysia and the Massachusetts Institute of Technology for extracting the peptide from the plant's root; all the research on humans and animals showing positive effects is done on Tongkat that is extracted via that patented method. This means that the grand majority—if not all—of the products on the market are fake. The plant does not grow in many regions, and it's impossible to ascertain the source of the plants used in the supplements. The active ingredient is a peptide, so it's impossible to guarantee effectiveness if it is not stored in a sterile vial. The exact ingredients and their quantity in the marketed supplements are unknown. Sometimes, they include ground-up generic Viagra and Cialis in these supplements; you're better off getting generic Viagra or Cialis if that's what you want. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 1990s. These supplements also contain irritants that can affect your intestine's ability to absorb nutrients and cause irritable bowel syndrome. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by validated laboratory methods.
  • I heard on social media that controlling Estrogen with medications like Anastrozole while on TRT is not a good idea. What is your opinion on this?
    A tiny minority of men on TRT do not experience an increase in Estrogen levels, but most of them do. Most men think of adverse effects related to elevated Estrogen in the context of gynecomastia and nipple sensitivity, but these are the least significant and take a long time to develop; supraphysiologic Estrogen levels in men have more common and more detrimental effects. Examine the list below: Estrogen is the female sex hormone; too much of it counters the benefits of the male sex hormone, Testosterone. So why diminish the effect of your Testosterone? Estrogen increases insulin resistance, increasing the risk of diabetes and weight gain. Estrogen increases Triglycerides, which is a type of fat that increases your risk of a heart attack. Estrogen causes water retention, making a man's face more round and puffy. The extra water can also raise blood pressure. Estrogen at certain levels may increase the risk of blood clots because it causes the liver to produce many clotting proteins. Estrogen at certain levels also causes depression, erectile dysfunction (ED), and low libido. Estrogen amplifies Testosterone's testicular shrinkage effect. Estrogen decreases IGF, decreasing the benefits of endogenous and exogenous Human Growth hormone. That does not mean we should get rid of Estrogen in a man. In the 80s, men on Testosterone were taking aromatase inhibitors--pills that reduce the conversion of Testosterone to Estradiol, controlling the Estrogen levels in the blood--daily, and they started getting heart attacks. Low Estrogen in a man causes: Blood clots! Yes, both low and high Estrogen are associated with clots. Erectile dysfunction (ED)! Yes, both low and high Estrogen are associated with ED. Low libido! Yes, both low and high Estrogen are associated with ED. Joint pain. When a man is on hormone replacement therapy, Estrogen levels must be physiologic, not too high but not too low. Every man has their happy medium when it comes to Estrogen levels. We'll make sure you stay there. We prescribe Anastrozole, Letrozole, and Exemestane to achieve this goal; collectively, these medicines are classified as Aromatase Inhibitors (AIs); each one of them has unique characteristics, and we will help you choose the right one for your needs and budget.
  • What are the costs of services rendered at your practice? Do you accept insurance?
    We do not accept insurance. We are happy to furnish you with any receipt or superbill for any service at our clinic, although we cannot guarantee reimbursement to you by your insurance company. Our Hormone Replacement Program: We charge per visit, but we calculated the average monthly price. Call us if you need any clarification. See pricing details and program description here: here. Botox: $10/Unit.
  • I don’t live in California. Can we do telemedicine?
    I am licensed to practice medicine only in California. Therefore, physical evaluations must be at my office in California. If you live outside California, I can still help you once we discuss how often you would need to be seen at my office. Many patients see me two times a year but live in a different state. We can arrange for blood draws and get medicines shipped to every state.
  • Why are injectable medication supplies such as syringes and needles dispensed at your office?
    This guarantees adherence to physician-recommended needle size and quantity of needles/syringes. Retail pharmacies often do not dispense the prescribed amount or needle size, as it depends on what they have in stock, which is inconvenient, and using the wrong needle size can cause trauma and scar tissue formation. We are aware that some patients purchase these supplies from various websites, but we advise against that because we cannot guarantee the sterility of these supplies. We purchase our supplies from world-class, reputable suppliers such as McKesson. However, we may still prescribe through retail pharmacies if it is more convenient for patients who live too far from our clinic.
  • Can I use my HSA/FSA/HRA account/card to pay my fees at Newport Health & Vitality?
    It is on a Case-by-case basis. You would have to try and see. We'll help you as much as we can.
  • I am on hormones, I sleep well, and I work out a lot. Why am I not seeing any gains?
    First, consider the practicality of your goal. Are you trying to get big like the fitness models in fitness magazines, or more like Arnold Schwarzenegger in The Terminator? Are you fixated on that 200 pound goal? If you're looking to become like the Incredible Hulk, you would have to be on at least 6-8 units of HGH daily and at least 800 mg of injectable steroids weekly; you're looking at roughly $3000 a month for all that, at least 1 pound of steak daily, and hopefully, you have all the time in the world to cook and work out. But you would also give up something more valuable than money: Your long-term health. It is these doses that are associated with irreversible heart failure and fatal cardiac rhythm abnormalities. When you hear about a jacked guy dying suddenly at the age of 54 while he was cooking or sleeping, now you know why. Guys also want to put that 200 pound statistic on their dating profile. Speaking of realistic goals, if you are under 5'10 unless you are exceptionally thick-boned, there is no HEALTHY way of weighing 200 pounds! And if you do it, it won't be sustainable, you won't look good, and you won't be healthy. So, don't focus on numbers; focus on how you feel and look. Your goals are practical; you are taking hormones and going to the gym, and your form is good, so why no gains? You keep interrupting muscle recovery and damaging your tendons. With weight lifting, less is more; think fewer reps, higher weights, and less frequent workouts. You can do yoga or cardio seven days a week, but you should not lift weights more than four times a week. The gain in lean mass occurs during muscle recovery, which usually takes 48 hours after muscle loading. You think you're eating enough, but you're not, which is the most common reason behind stagnant gains. To support the anabolic process, you must consume 3 grams of animal protein for every pound you currently weigh daily. This requires discipline, motivation, time management, and meal prepping. You may control your time, the intensity of your workouts, your hormone levels, and your animal protein intake, but you cannot exceed the limits of the muscle-building machinery at the biomolecular level because your genes and age set these. Setting realistic, sustainable goals that do not affect your long-term health is essential. Your growth journey should include both physical and spiritual growth. Enjoy the process of self-improvement and learn to love yourself, appreciate what you have, and be grateful for it.
  • I heard that many pharmaceutical companies are making oral Testosterone. I have also seen social media influencers and some doctors promote oral Testosterone. Should I consider it?
    No! I'll explain why. When a man has suboptimal testosterone levels (<400 ng/dl), the goal is to get the level to at least 600 ng/dl, preferably over 800 ng/dl. In clinical practice, many men feel their best when it's 1000 ng/dl. The point here is that assessing the efficacy of testosterone replacement therapy (TRT) requires both target levels as well as a man's subjective feeling of "joie de vivre" from the TRT. The clinical trials for novel oral testosterone formulas--such as Jatenzo and Kyzatrex--did not show significant improvement in testosterone levels, and the very grand majority of patients on these formulas had a post-treatment level that was under 800 ng/dl. The follow-up phase was around six months, so long-term efficacy and adherence are still being determined; however, we can make an educated guess that they are neither effective nor easy to adhere to in the long term. We know they're ineffective because clinical practice shows that most men feel their best when their level is over 800 ng/dl. Long-term adherence is terrible because all these formulas require a twice-daily dosing regimen. We know from clinical experience that almost all twice-daily regimens fail. People tend to forget one dose or the other. Why are these drugs ineffective? It's because your liver breaks them down before they enter the rest of your body. That's why the dosing is extraordinarily high and twice a day. The manufacturers of these brand medicines claim that lymphatic absorption patented biotechnology prevents liver breakdown, but their own published data argue otherwise. To understand this, let's look at a real-life example: John is on brand-name oral Testosterone Kyzatrex. He takes 400 mg twice a day, which translates to 800 mg per day and 5600 mg a week. His testosterone level is 650 ng/dl on this regimen. Jack is on injectable Testosterone. He injects 100 mg once a week. His testosterone level is 650 ng/dl on this regimen. As you can see, it takes John 56 times more testosterone to achieve the same results as Jack. Also, John has to deal with this daily vs Jack, who injects every Sunday. If John does not feel benefits with a testosterone blood level of 650 ng/dl, then he's SOL because 400 mg twice a day is the maximum dose of Kyzatrex he can be on. Compare that to Jack, who is on a relatively low dose of injectable Testosterone with plenty of room to increase his dose. Also, does anyone know the long-term consequences of swallowing 5600 mg of Testosterone weekly? The follow-up time for these studies was less than a year! But it gets even trickier when you consider access. Access to a medication in the United States is determined by the sticker price of the medicine, coverage by insurance plans, and pharmacy stock/manufacturer supply, which in turn follow demand. Consider the real-life example below: Injectable Testosterone through my practice is procured for an average of $80 a month when the dose is 200 mg weekly. That's the sticker price, so there's no insurance involvement. The cost of one month of Jatenzo is currently $1000! The cost of Kyzatrex is unclear, but per GoodRx, it is a "limited distribution drug," most likely due to its extremely high price, likely higher than $1000 a month. Now you see how these sticker prices limit access. Therefore, patients taking Jatenzo or Kyzatrex must obtain them through insurance, but insurance coverage for brand medicines like these is notoriously inconsistent. Insurance companies change their coverage capriciously without prior warning or explanation. Suddenly, the plan no longer covers the medicine at all, requires different criteria to cover, covers a smaller portion of the price, or a shorter duration of therapy. Sometimes, your plan stays the same, but you change doctors, and now the new doctor needs to resubmit their medical necessity documents to the insurance company. Now you see how insurance coverage limits access. But say your doctor, plan, and insurance company all remain the same (infrequent these days); because demand for these brand medicines is very low, manufacturers may stop making them or the pharmacy may stop restocking them; sometimes, the insurance company whimsically decides not to reimburse the pharmacy after it had dispensed the medication to you, so the pharmacy stops stocking the medicine; all of these scenarios are guaranteed to leave the few patients who take these medicines high and dry. That's not to say that oral Testosterone is a bad option for everyone. Women require 10% of the amount of Testosterone that men do, making oral Testosterone a compelling option for them. Still, oral Testosterone for women is available at a very affordable price through various reputable compounding pharmacies all over the United States, negating the need for the costlier and inaccessible brand of oral Testosterone. But what about men who are unable to inject, such as men who have hand arthritis, carpal tunnel syndrome, or needle phobia? These men can be on topical/transdermal Testosterone cream; applying a cream on the shoulder daily is easier than taking a pill twice a day. Although less effective and less affordable than injectables, it is more effective and a lot cheaper than oral brands. So why are some doctors pedaling brand oral Testosterone on social media for men? I have no idea. But if you figure it out, let me know. Dr. Yazan Abdullah MD MPH
  • Given the possible side effects, the cost, self-injection, and regular follow-up requirements is Testosterone Replacement Therapy (TRT) worth it?
    If TRT were not worth it, many men would not take it. The dramatic benefits outweigh the costs, risks, and upkeep. With a doctor-managed TRT program, men who would otherwise not have gone to the doctor get their health assessed periodically, which ensures preventive care and early detection and treatment of cancer and metabolic disease.
  • I want to go on Trenbolone. What's your opinion on it?
    Trenbolone is not bioidentical, which means it does not exist in Mother Nature. We use it in cattle. Months before a cow is set for slaughter, it is given Trenbolone; it makes the cow beefier so that it can feed more people. Trenbolone is more potent than testosterone, building lean mass in the cow quicker. Remember, a cow's life span on the farm is shorter than that of a human. Longevity is not a concern. So why not use Trenbolone in men so that they, too, can get jacked quickly? Human longevity, specifically in the context of heart health and function, concerns humans. We should only take a substance if its long-term safety profile is known. The cow is slaughtered a few months after it goes on Trenbolone, so we have no idea what's happening to its heart, kidneys, clotting factors, sexual function, or blood pressure in the long term. Moreover, altering a hormone's molecular structure should never be taken lightly. For instance, when the Testosterone molecule is modified to become Trenbolone, we are not only changing the anabolic or androgenic potency, but we are also altering many unknown or poorly studied interactions between the hormone and various organ systems in the body. I hope you avoid Trenbolone.
  • I am on keto, all meat, and all the social media gurus recommend adding as much salt as I want; what are your thoughts?
    When someone is on an all-protein or all-meat diet, sometimes described as carnivore or keto, their carbohydrate intake is minimal. As a result, they need more water throughout the day since protein foods are water-deficient, while carbohydrates are water-rich. Salt increases thirst, which makes people on the keto diet drink water to ensure sufficient hydration. In this case, the increase in table salt would prevent low blood pressure, not cause high blood pressure. With a functioning kidney, any excess salt would be expelled from the body by the kidney. However, this advice does not work with men on TRT, and I highly recommend against using excessive table salt even if you are on a strict "keto" diet. Testosterone may cause the kidney to be less eager to expel salt and hence may cause a rise in blood pressure if coupled with excessive table salt intake. So, if you're on TRT, try to avoid salt or use minimal amounts with your steak. To ensure hydration, don't use salt. Just drink lots of water.
  • How much protein should I consume?
    Aim for a daily intake of 1.5 grams of animal protein per current body weight in pounds. But if you are trying to increase lean mass, you need 3 grams daily. Animal protein includes meats, milk, and eggs.
  • Should I drink "protein shakes?"
    The most challenging aspect of health, fitness, and bodybuilding is ensuring adequate animal protein intake daily. We, therefore, understand the appeal and convenience of "protein shakes." But we can't tell if protein exists in the "shake." "protein shakes" are considered a "dietary supplement" by the FDA, meaning they are not regulated to the extent that food or medicines are. Manufacturers are responsible for ensuring that their products are not harmful, though many companies do not test for safety or efficacy before marketing them. The FDA created Good Manufacturing Practices (GMPs) to help minimize adverse issues, but compliance with these procedures remains a concern. In 2017, about a quarter of supplement-manufacturing companies whose products were tested received citations related to purity, strength, and ingredient content. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 1990s. These supplements also contain irritants that can affect your intestine's ability to absorb nutrients and cause irritable bowel syndrome. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by laboratory methods.
  • Should I take creatine supplementation?
    No! Your cells are capable of assessing their creatine needs and producing creatine accordingly. We are aware of the creatine supplements sold on social media. However, the research on creatine is low-quality, inconclusive, and sparse. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 90s. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by laboratory methods.
  • Does Testosterone Replacement Therapy increase blood pressure?
    That is the most loaded question I get from my patients when I see them for the first time. So here's the loaded answer: Yes and no! Testosterone increases appetite, which may increase daily caloric intake. But Testosterone also increases metabolic rate. There should be no weight gain besides lean mass with proper exercise. Sometimes, the weight stays the same, but it gets redistributed as more fat is burnt and more muscle is built. Either way, an increase in appetite leads to increased caloric consumption. Not all calories are created equal. A calory is a calory, but where the calory comes from matters. When derived from carbohydrates, it activates lots of insulin; if derived from protein or fat, it activates a lot less insulin; the more insulin, the more salt and water retention in the kidney, the higher the blood pressure. Additionally, carbohydrates--from their name including "hydrate"--contain a high percentage of water, which may also increase your blood pressure. Testosterone increases the production of red blood cells, which is desirable as it makes us look more youthful and guarantees adequate oxygenation in a body working at a higher metabolic rate and actively building muscle. However, if this effect is too extreme, as we see with men who don't have a doctor monitoring their labs or with men who use incredibly high doses, the increased red blood cell production thickens the blood and raises the blood pressure. Testosterone is the source of estrogen in both men and women. That's why we have to monitor estrogen in a man on Testosterone. Suppose estrogen gets too high because you skip your doctor visits or you are getting hormones from an unqualified facility (Telemed hormone mill or HRT chains manned by non-physicians) or pellets. In that case, it will cause salt and water retention, raising blood pressure. Moreover, estrogen increases insulin resistance, which may lead to higher insulin levels, which increases salt and water retention and blood pressure. Testosterone has multiple psychiatric effects. It improves mood, youthfulness, and motivation, possibly leading to excessive resistance training (weight lifting), especially when you want to attain that jacked look. The effect of exercise on blood pressure depends on the type of exercise. Endurance exercise, AKA "cardio" or "aerobic," reduces blood pressure and improves cardiac function. Strength training (weight lifting) increases blood pressure. It is, therefore, extremely important to have a good balance of both when you are on Testosterone replacement therapy. When you combine endurance and resistance training, the pressure effects balance out, giving you a more robust, healthier heart. However, large doses of Testosterone, or any other androgen, for that matter, may increase irritability by elevating the resting sympathetic nervous system tone, which would raise blood pressure. Lastly, it is unknown whether non-bioidentical androgens such as Trenbolone or Winstrol have properties that make them bind to the aldosterone or cortisol receptor, causing an increase in blood pressure. It is also not inconceivable that extremely high doses of Testosterone itself cause binding to aldosterone and cortisol receptors. Remember, all androgens come from the same steroid molecule that also serves as the precursor of less desirable steroids, such as aldosterone and cortisol, which increase blood pressure. Are you confused enough? I am about to confuse you even more, so take a deep breath! Testosterone can--and quite often does--reduce blood pressure. Just ask the young 25-year-old men with high Testosterone levels and blood pressures under 120/80, and that's despite all the burgers they eat. The higher metabolic rate induced by Testosterone and exercise reduces midsection adiposity and blood pressure. The antidepressant, motivator, energetic, and euphoric effect of Testosterone improves productivity, sleep, sexual function, and appearance and reduces the stress related to all of these issues above. These psychological components have a profound impact on blood pressure since blood pressure is mostly neuropsychiatrically driven. Men who are on TRT experience positive reward reinforcement, which often promotes healthier keto and paleo eating habits; the associated reduction in carbohydrates also reduces blood pressure. They look in the mirror and see an improvement in their appearance; then, they start cutting back on smoking and drinking to look even better, which also reduces their blood pressure and increases their longevity. With the appropriate dosing and monitoring by a qualified doctor (not a nurse, a physician assistant, or a remote medical director who has no say in any part of the treatment plan), a mild increase in red blood cells is good for you; the red blood cells release vasodilatory chemicals such as nitric oxide that reduce blood pressure and at the same time deliver lots of oxygen to give you the energy you need to exercise and be productive, both of which reduce your blood pressure. Keeping your doses in check, cycling higher doses with a decent, nonjudgmental doctor who uses bioidentical hormones only, and avoiding veterinary steroids such as Trenbolone can ensure that you do not experience aldosterone and cortisol effects and stay out of the troubles of high blood pressure, lipodystrophy, puffy face appearance, and diabetes. So now, back to the original question. Does Testosterone increase blood pressure? I gave you the long answer. Here's the short one: Testosterone DOES NOT DIRECTLY increase blood pressure. When used appropriately It may decrease it. When used inappropriately, it may increase it.
  • How many units of Botox will i need? How much will it cost?
    Dr. A needs to examine you and provide a comprehensive aesthetic consult in order to determine how many units you would require. However, men usually need 70-80 units and women usually need 50-70 units. Currently we charge $10/unit.
  • Are there any Botox Pre-Treatment Instructions?
    Avoid taking aspirin, non-steroidal anti-inflammatory medications, St. John’s Wort, Omega 3 fatty acids (fish oil), and vitamin E supplements for five days prior to treatment to reduce the risk of bruising or bleeding at the injection site. Arrive at your appointment with a clean face, no skin product or makeup.
  • Are there any Botox Post-Treatment Instructions?
    Do not lay down for 2 hours post treatment. Contract the facial muscles in the area injected every 15 minutes for 1 hr after treatment. Do not rub the area treated. Do not exercise for the first 12 hours after treatment. You will not see full results for up to 7 days after treatment and the maximum effect may take 2 weeks to appear. The average Botox treatment last 3 to 4 months. After repeat treatments the effect may last longer. First treatment usually lasts the least. Wait 14 days before any rejuvenation procedures such as microneedling and laser. Call our office if you have any concerns.
  • Do you treat hyperhydrosis?
    Yes we use neuromodulators to treat it. Each side requires 100 units. Cost is $10/unit, so $1000 per side.
  • I live far from Newport Beach. Can I do my labs at a lab in my area and follow up with you via telephone/video call?
    Yes, we understand the inconvenience of the commute, so for patients who are not close to us, we can do that as long as we see you at least twice a year here at the office.
  • Is there a No-Show Fee/Appointment Cancelation Policy?
    We are committed to providing exceptional care. The physician's time is valuable. Moreover, when one patient cancels without giving enough notice, they prevent another patient from being seen. If it is necessary to cancel or reschedule an appointment, please call or text us at (949) 229-5257 at least 24 hours before the appointment; otherwise, a $150 fee will be applied to your account. Notification allows the practice to better utilize appointments for other patients in need of prompt medical care. Thank you for understanding.
  • What's the process and pricing to get into your hormone replacement program?
    Here! (scroll down the page)!
  • Can I use insurance for the medications you prescribe?
    It depends! Insurance does not cover the class of medicines Dr. Abdullah prescribes for hormone replacement therapy. And in the rare occasions they do, they don't cover the dose or strength he deems effective. A one-size-fits-all approach would not deliver results and patient satisfaction. Luckily, these medications--when purchased through our program--are affordable! When you use "insurance" to pay for something, an entity other than yourself is paying. Said entity then must have proof of "medical necessity" to pay. However, what we deem medically necessary differs from what the insurance company deems necessary, leading to delays in therapy and placing an unacceptable liability on the prescribing physician. There is however one exception: If you are needing one of the novel weight loss drugs such as Ozempic, Mounjaro, or Zepbound, as part of your HRT program with us or if you are with us just for medical weight loss, then rest assured that Dr. Abdullah will do whatever he can to get your insurance plan to cover the partial--or hopefully the complete--cost of the medicine!
  • Your services are too costly; I have seen much lower prices elsewhere. My friend’s Primary Medical Doctor (PMD) is prescribing Testosterone, and it’s through insurance.
    Cost is relative, and you get what you pay for. Your biggest asset is your health, inside and out. Considering what we offer as a full-suite comprehensive hormonal health clinic, ours is a value proposition. Our vitality program is a form of self-investment. You will experience results that improve your personal, social, and occupational life. A PMD who is not a hormone specialist may not necessarily dose appropriately, treat side effects, or optimize estrogen levels because they lack the time and expertise and are limited by the insurance company or the employer's "guidelines." These "guidelines" are to reduce costs and maximize profit for these entities, not improve your life's quality.
  • Do you prescribe or recommend Anavar, Winstrol, D-Bol, or Anadrol?
    Anavar/oxandrolone and Winstrol/stanozol are anabolic steroids related to testosterone, specifically dihydrotestosterone (DHT). It's easy to understand their appeal in the fitness industry. They are oral--usually dosed twice daily; the body does not convert them to estradiol, obviating the need for aromatase inhibitors. At low to moderate doses, they exert an anabolic effect without causing undesirable androgenic effects such as acne and accelerated hair loss. Some bro-science peddlers will tell you that they are good for "bulking" cycles, and some will tell you that they are good for "cutting" cycles; of course, this makes no sense. I do not recommend them for various reasons. They reduce "good" cholesterol, cause various types of liver disease, and increase water retention. The extra water raises blood pressure and causes a puffy face. Because they are very different from testosterone and DHT, we don't know what else they are doing in the body. Their side effect profile and everything we know about them come from studying subjects taking daily doses under 25 mg. The bodybuilding dose is usually at least 50 mg daily. Once dosed over 20 mg, they will exert the same undesirable androgenic effects of testosterone, such as acne, which defeats their very purpose. Additionally, unless they are fake, they cost a lot more than injectable testosterone. If a man temporarily wants a greater anabolic effect or wants to "go on a cycle," the best way to do it is just to increase the dose of testosterone! You may need to take the aromatase inhibitor more frequently or an antibiotic or topical/oral finasteride for your hair or acne; still, this is a far easier, safer, and more cost-effective approach than taking Anavar or Winstrol. What about D-Bol and Anadrol? Anadrol/oxymetholone is another oral steroid; it has the same problems and cost as Anavar and Winstrol, yet it is a weaker anabolic. There's no reason to take it. Dianabol, AKA "D-Bol"/methandienone is also an oral anabolic steroid that's as potent as Anavar and Winstrol, except it has the same problems and gets converted to a type of estrogen that's hard to get rid of. Again, there's no reason to take it.
  • What lab method do you use to test for Testosterone and Estrogen?
    We use serum/blood testing through LC/MS technology; the samples are analyzed by state of the art technology at Quest Diagnostics, which is a world class laboratory. We do not believe that salivary testing is accurate. To ensure that our treatment plan is effective and safe, we include a comprehensive laboratory panel that exceeds the standards of hormone replacement therapy and primary care. Furthermore, we only use the most accurate methodologies for our hormone testing, such as Chromatography combined with Mass Spectrometry. For these reasons, getting the results takes up to 10 business days.
  • How long does it take for lab results to come back? What is the blood work turnaround time?
    To ensure that our treatment plan is effective and safe, we include a comprehensive laboratory panel that exceeds the standards of hormone replacement therapy and primary care. Furthermore, we only use the most accurate methodologies for our hormone testing, such as Chromatography combined with Mass Spectrometry. For these reasons, getting the results takes up to 10 business days. For convenience, you can use our mobile phlebotomy service, get your blood drawn at home or the workplace, and then review lab results with Dr. Abdullah via telephone.
  • What's your opinion on extracorporal shockwave therapy (ESWT) for the treatment of erectile dysfunction (ED)?
    ESWT is an investigational modality, which means that urologists (doctors who specialize in diseases of the penis) have yet to figure out if it's of any use in treating ED. ESWT's efficacy is anecdotal. It's also costly. If Viagra and Cialis don't work for you, we can prescribe intracavernosal agents such as "Tri-Mix," which is more effective and more affordable than ESWT.
  • What is your opinion on longevity and health regarding Sauna, Infrared, and cold plunging?
    Exposure to extremes of heat and cold for health benefits is under investigation. The studies are prospective cohorts with likely many confounding factors. At this juncture, quality data and evidence are lacking.
  • Is your lab panel ("blood work") comprehensive enough? I want "everything checked."
    When it comes to the specialty of hormone replacement, our lab panel is meticulously comprehensive. We don't believe in ordering unnecessary labs just to inflate the price, a practice we know some medspas engage in. As part of our commitment to providing comprehensive service, our lab panel includes all the labs your primary care physician would ever need. This means you can complete all necessary tests in one place, saving you time, money, and effort. You can access your labs anytime, anywhere, so you can show them to your primary care physician.
  • I cannot go to the gym or eat healthy because I am too busy with family and work-related issues; my life is out of control now. Should I stop taking testosterone?
    This logic denotes the misconception that the sole benefit of testosterone is exercise tolerance, motivation, and anabolic gain. I cannot overstate the importance of testosterone in energy, motivation, mood, bone density, and fat burning. If you are enduring a psychosocial stressor—such as a work-related, time-sensitive project, a divorce, or funeral planning—does that mean you should stop taking the medicine that is giving you energy, a positive mood, and faster metabolism?! Do stressed-out people not need a mood and energy booster?! Do people who don't go to the gym not need a medicine that boosts their metabolism?! Stress causes the body to produce a lot of cortisol, the principal stress hormone. Cortisol is a catabolic hormone that breaks down muscles; it also raises insulin levels, increasing midsection fat. When you're stressed out, you're not just not building muscle; you're actively breaking it down and depositing fat in your midsection simultaneously! Testosterone counters these effects; it prevents the binding of cortisol to its receptor in the muscle, protecting it from breaking down. Testosterone lowers insulin levels, preventing midsection adiposity. So please don't stop taking your testosterone when you're stressed out or when you're not going to the gym. If anything, that's when you need testosterone more than ever.
  • Hormones through your ordering/refilling portal are "expensive"; I see them advertised elsewhere on GoodRx at a fraction of the cost, and they are cheaper through my dealer or gym trainer.
    Dear prospective patients, none of our services is expensive, and we are proud to be accessible to anyone not wealthy. That's because we believe that hormone therapy (when indicated) should be accessible to everyone who benefits from it. The cost of Testosterone--as well as all other medications we prescribe through our portal--includes the price of our labor that is related to your chart review, prior consultation, a review of your labs, and any interaction between you and the Doctor, as well as any care coordination labor involving our staff and the delivery pharmacy; so you are paying for not just the drug; you are paying for the doctor's work involved in the prescription and monitoring of the medication (chart review) as well as the convenience. Since transparency is crucial to us, we have disclosed this on our medication ordering/refilling website, our main website, and the intake paperwork you signed upon your initial visit; you are paying for quality, consistency, and convenience; a chart review is considered a remote consultation with substances that are controlled by the state and federal government, such as Testosterone. Still, when you compare our service to the $300 monthly subscription service to some random testosterone mill where a nurse or some naturopath underdoses you with "branded" Testosterone with no way for you to know the actual manufacturer and expiration date, ours is a value proposition. We hope you understand that. Some clinics make you come weekly for shots; when you calculate what they charge you for each shot and take into account the amount they're injecting you, you quickly realize that our prices are more affordable. As far as your gym trainer, if he's selling you a 20 ml Testosterone bottle for $10 with a concentration of 300 mg/ml, keep in mind that the bottle is most likely not sterile, most likely does not include pure Testosterone, probably has some traces of "tren" in it. Oh yeah, and the actual concentration is not 300 mg/ml. It could be anything from 50 to 150 mg. Also, the HCG you are getting from your dealer, Mexico, or the internet is fake. The "gonadorelin" you are getting from the local neighborhood Testosterone franchise, the internet, and Mexico is fake, as well as the "peptides." We proudly state that we don't promote, prescribe, or sell any fake hormones or peptides. P.S.: Please note that GoodRx prices are subject to change per month and per pharmacy, are inaccurate, and do not reflect stock availability at said pharmacy.
  • I am not interested in your vitality or obesity program; I just want a Rapamycin course as an anti-aging approach to my overall health.
    Yes, please set up a consultation. I will collect your medical history and happily prescribe it. Learn more here!
  • Do you treat gender dysphoria in men? I am a man who wants to transition to a woman.
    At this time, I do not offer that. The estrogen replacement therapy required for transitioning to a woman involves high doses of estrogen that tend to cause clots and severe metabolic and psychiatric diseases.
  • How do I dispose of used needles and sharps?
    Please purchase a sharps and biohazard disposal container from our office or from Amazon. Once the container is filled, you can take it to a local sharps and biohazard disposal facility. If you live in Orange county, see location description below. If you live in another county please go to: https://calrecycle.ca.gov/epr/pharmasharps/sharps/ Orange county residents: Irvine Household Hazardous Waste Collection Center, 6411 Oak Canyon, Irvine, CA 92618. Hours: Tues-sat 9 AM-3 PM. Limit to disposal: 125 pounds per trip.
  • I still have questions!
    If you have any other questions, call/text us at 949-229-5257 or info@nhvitality.com.
  • Do you treat obesity? Do you prescribe Ozempic®?
    Yes, as a Hormone Replacement expert, Dr. Abdullah has advanced knowledge in metabolic and obesity medicine, including the prescription of Ozempic® and all the other injectables within the GLP-1 class (Trulicity®, and Mounjaro®) to ensure that you are able to get treated, in case one of them is in shortage or not potent enough. He also believes in practical effective coaching to both achieve weight loss and maintain it. We don’t take insurance for Dr. Abdullah’s consultation; the first visit is $300, and subsequent visits are $250. The medications cost $900-$1500 monthly, so it’s an investment. Dr. Abdullah will do his best to get this medication covered by your insurance company, and sometimes, the copay is zero for some lucky patients. If your insurance company is not covering any of the cost, we still think it’s worth it, as they are very effective, and may reduce weight by 10-15 pounds per month! In 3-4 months, you may achieve the same results as a gastric bypass/bariatric surgery, minus the surgical complications, cost, and chronic vitamin and mineral deficiency that ensues with these surgeries. The health benefits of treating obesity are too many to list. Look at it this way: One cannot live their best life if obese. We believe in body positivity as a valid and much-needed social movement, but obesity is unhealthy and will reduce your life expectancy, and we don’t think that its glamorization is body-positive. With appropriate coaching by Dr. Abdullah, you would not have to be on these expensive medications permanently. The idea here is to coach you effectively while you’re on them, so you can maintain your weight when you stop them save your money, and look good for a nice vacation!
  • I don’t believe I can lose weight. I have tried keto, “Lipo-Amino”, stimulants, went vegetarian for a while, exercised my ass off, hired a trainer, did weight watchers, meal planning, did Ozempic, and nothing worked. I believe I am genetically destined to be obese. Both of my parents were.
    Well, I hope you give Dr. Abdullah the chance to prove you wrong. He loves this challenge! The science of metabolism is a moving target. We know today more than we did yesterday. I am current with all the obesity medical knowledge and novel pharmaceutical marvels that can help people like yourself. It is true, that there is an obesity genetic propensity among a large subset of the population, but that is not enough to become--and stay--obese. Also, the genetic factors can be counterbalanced by certain practical and sustainable lifestyle modifications that we will teach you. Obesity is a form of malnutrition that results from food dependence, which often occurs in the context of underlying mental disorders. And to add insult to injury, these mental disorders are often treated with drugs that increase appetite and cause undesirable side effects such as erectile dysfunction, weight gain, and flat affect! Go figure. We use a multifaceted approach as well as Ketamine to treat underlying depression and cravings. We will teach you to evaluate the food in front of you quickly and practically so you can make the right decisions when you don’t have much time to think. We’re not going to make you starve or count “macros” or any of that nonsense. Even if you don’t have a genetic propensity for obesity and yet struggling with it, I still think it’s not your fault: Junk and ultra-processed foods are everywhere; we can’t escape them; we are also a product of our upbringing; moreover, the field of nutrition science is based on very low-quality research, and special interests influence the government-issued food pyramid.
  • Will I be on Ozempic permanently? If my insurance plan does not cover the cost, it gets expensive! Once you stop the medicine, you get all the weight back. Would that not be demoralizing and a waste of my hard-earned money?
    It may take us six months to two years to achieve our goals, depending on how many pounds we need to shed. It’s a mental and physical marathon, not a sprint. Once we achieve the goals, we will get you off the medicine, but only when we feel that you have rewired your brain and can maintain the weight loss. Remember, obesity is associated with every disease under the sun. Hence, these novel injectable drugs are worth every penny. But yes, without lifestyle modification, you would get the weight back. One of the main benefits of novel weight loss injectables like Ozempic is that they restore an obese person’s belief that they have a healthier version inside of them that’s yearning to come out, and that alone has tremendous transformative power.
  • What is “Ozempic Face”?
    “Ozempic Face” is fake news brought to you by the misinformation of social media influencers! Any person--whether or not on Ozempic—will have more accentuated wrinkles if they lose lots of weight. Even babies have wrinkles around their mouths. So, it’s not “Ozempic Face.” It’s the underlying beautiful you, and embracing is what body positivity is! The recent social media blitz about “Ozempic Face” is to replace weight anxiety with face anxiety, so you’d go get fillers! don't fall for this!
  • My friend just did Ozempic/Semaglutide, and three months in, no results! Can you explain that?
    It could be due to one of the following reasons: Inappropriate dosing: Sometimes, we need a higher strength or a more potent version. Concurrent B12 deficiency. Unaddressed concurrent mental illness. Ineffective lifestyle and nutritional coaching Concurrent undiagnosed hormonal deficiency: For example, suboptimal thyroid or Testosterone. Tolerance: Your brain has developed tolerance to the drug, and it now knows that you're trying to trick it into thinking that your stomach is full. Tolerance is genetically determined and occurs with prolonged use, which is why we need to coach you so you can get off the drug. We will address all these issues when you join our program. We test you for hormonal and vitamin deficiency at the beginning of our weight management program.
  • How do you specialize in metabolic medicine yet don’t discuss body fat percentage?
    We use everything we can to help you lose weight. Fat percentages, pods, and waistline measurements are just numbers. We focus primarily on your health, your goals, how you feel and how you look.
  • What about "Ozempic dreams," "Ozempic hair loss," and "Ozempic Gall Bladder and Abdominal pain"?
    Ozempic, like all other drugs within the same class, works on the brain; it's how it reduces your appetite and makes you eat less. All medicines that work on the brain may have idiosyncratic psychoactive effects that people with a particular genetic makeup are prone to. Still, this is not a reason not to lose weight. As far as hair loss, this is a rare and clinically insignificant effect that occurs with rapid weight loss, so it has nothing to do with Ozempic. The same applies to gallbladder issues and abdominal pain. Please communicate with us your symptoms, and Dr. Abdullah will help you alleviate them and assess any need for further investigation and management. .
  • I am what they call a “Bear” in the gay community, which is not an undesirable look, and I feel good. I am body-positive. Some find my protruding belly very sexy; I find it sexy. Why would I need to lose weight?
    Body positivity is a great attitude. Everyone should have it! But body positivity also means that no matter who you are, you should love your body enough and treat it like a temple; in return, your body will help you live life to the fullest. Obesity greatly reduces an individual's lifespan. Even if you are not interested in living long, obesity reduces your overall quality of life.
  • What's the process and pricing to get into your weight loss program?
    Here! (scroll all the way down the page for process and pricing)
  • What is Semaglutide?
    Semaglutide is the generic name of Ozempic and Wegovy, both registered trademarks of Novo Nordisk, a Denmark-based global pharmaceutical company.
  • What is an Ozempic baby? I heard that even if I am on birth control pills, I may get pregnant on Ozempic. Is that true?
    Yes, there are two reasons behind this: One of Ozempic's effects—and all other injectables in its class—is to slow down the rate at which your stomach passes ingested food and medications to the small intestine. The longer it takes for a drug to reach the small intestine, the more likely it is to fail therapeutically. The small intestine is where most medicines are absorbed. Secondly, one of the adverse effects of obesity is that it reduces the activity of your ovaries; it's a condition we call secondary hypogonadism, and it affects both obese men and women. When you lose weight precipitously, the brain sends signals to your ovary that increase ovarian activity, which may override the inhibitory effect of the hormonal birth control pill. When you start Ozempic or any other drug in its class, I highly recommend that you stop birth control so that your period returns and you're able to time sex in a way that does not lead to pregnancy. Once your period returns, you can use the following method to time unprotected sex: This method works best if your cycles are usually between 26 and 32 days long. Count the days in your menstrual cycle, starting with the first day of your period as day 1. Continue counting each day of your cycle until your next cycle starts. On days 1-7, you can have unprotected sex, but you may have menstrual bleeding on those days. On day 20 through the end of your cycle, you can have sex. When you get your next period, start counting as day 1. To help track your cycle, you may use a tool such as CycleBeads: https://www.cyclebeads.com/ CycleBeads has an app for monitoring cycle days.
  • Patents protect Ozempic and Wegovy. How is it possible for them to make a "generic"?
    Yes, but due to a worldwide shortage of brand medicine related to the manufacturing of the patented injection pen technology in the face of unprecedented demand, the US government allows the manufacturing of generic versions.
  • There are many internet-based "clinics" and spas offering Semaglutide. How did you choose your source?
    We chose this particular source for two reasons: One: The biopharmaceutical company that manufactures the Semaglutide is cGMP compliant, meaning the manufacturing standards meet the FDA's stringent requirements, especially for peptides. Two: The pharmacy compounding the Semaglutide, is licensed to ship sterile injectables to California. Compared to the rest of the United States, California has the highest standards regarding the compounding of sterile injectables; this is why, even within the state itself, very few pharmacies have licenses to compound sterile injectables.
  • Why should I get the compounded version of Zepbound/Mounjaro/Wegovy/Ozempic versus the brand?
    The compounded drugs contain the active ingredient in the branded drugs. Reputable world-class compounding pharmacies in the US procure bulk freeze-dried active ingredients from CGMP and FDA-approved biotechnology facilities located in China. These Chinese manufacturers are state-of-the-art and listed on the official Chinese stock exchange. Unlike the branded products with a patented autoinjector pen, compounded versions are shipped to the patient in a vial; the patient is required to draw the solution and self-inject. It's important to state that not all compounded versions are created equal; China has many biotechnology companies, and not all are FDA-approved. The recent reports of product bacterial contamination and impurity are related to these sources. We recommend against purchasing these products directly from the med spa or an online "provider." The product is likely illegitimate or expired if you receive more than one month's supply at a time or if it arrives as powder or liquid at room temperature. The branded versions are never reliably stocked at the pharmacy. There are various reasons behind that. Demand for these brands is at an all-time high; supply chains lament shortages in the autoinjector pen apparatus; manufacturers may also purposely reduce supply to inflate prices. But there is another important reason why pharmacies often don't reliably stock these medications: Inadequate reimbursement from the insurance company; for example, say, a pharmacy purchases Wegovy for $1000 from the manufacturer Novo Nordisk; you have an insurance plan that says that Wegovy is "covered" and your copay would be $50. You pay the $50 at the pharmacy, and the pharmacy hands you a Wegovy pen. The pharmacy will then bill the insurance company $950 for the Wegovy and $10 for storing and dispensing it to you. However, the insurance company refuses to pay the $960 it owes the pharmacy; It pays only $760$, so the pharmacy loses $200! The pharmacy wants to stay in business, so it chooses not to stock the medication. The same situation applies to coupon-based 50% discounts on these brand medicines. Compounded versions are not only a lot more affordable but also more reliable in terms of stock availability at the dispensing pharmacy. Consider this scenario: You start Wegovy and complete a month of therapy, and then Wegovy disappears at all the pharmacies in your town; you and your doctor now scramble to find an alternative source to no avail. This situation not only causes anxiety to the patient and the doctor, but it also disrupts the treatment plan, disheartens the patient, and runs the risk of all sorts of mental and eating disorders from the on-again, off-again dosing. We can prescribe these medicines for short-term use, but there should be at least three months of uninterrupted therapy. Currently, the stocking of these medicines changes drastically from one month to the other, preventing continuity of care. We hope this changes, but until then, the compounded version is a more affordable and reliable path to weight loss.
  • I see Instagram ads for many telehealth companies offering "Generic" Ozempic and medical weight loss services. There are also medspas everywhere offering semaglutide. How is your service different?
    It's crucial to understand that subscribing to an Instagram telehealth company or a medspa might only provide you with the medication without a thorough laboratory and clinical evaluation by a qualified doctor. Even if they claim the program is 'doctor-managed' or 'doctor-supervised,' the reality is that no doctor reviews your labs. If you are struggling with weight, you need metabolic medicine managed by an actual doctor who will give you updated practical counseling and comprehensively evaluate and optimize your hormones, vitamins, sugar, and iron levels. We need to identify all the reversible factors slowing your metabolism. That way, you will achieve more significant weight loss and a higher likelihood of keeping it off.
  • I forgot to store my semaglutide in the fridge. I was not home when they delivered the cold-packed medication, and now it's room temperature. Does it still work?
    All protein/peptide-based pharmaceuticals should be stored in the refrigerator to retain their long-term potency. However, as long as the ambient temperature is under 86 degrees, these medicines are stable for eight weeks. We err on caution and recommend no more than three days at room temperature. If it's been three days or less, your semaglutide should work fine.
  • How long does it take for lab results to come back? What is the blood work turnaround time?
    To ensure that our treatment plan is effective and safe, we include a comprehensive laboratory panel that exceeds the standards of hormone replacement therapy and primary care. Furthermore, we only use the most accurate methodologies for our hormone testing, such as Chromatography combined with Mass Spectrometry. For these reasons, getting the results takes up to 10 business days. For convenience, you can use our mobile phlebotomy service, get your blood drawn at home or the workplace, and then review lab results with Dr. Abdullah via telephone.
  • I don’t live in California. Can we do telemedicine?
    I am licensed to practice medicine only in California. Therefore, physical evaluations must be at my office in California. If you live outside California, I can still help you once we discuss how often you would need to be seen at my office. Many patients see me two times a year but live in a different state. We can arrange for blood draws and get medicines shipped to every state.
  • Why is the Semaglutide you prescribe combined with vitamin B12?
    From a legal perspective, compounding pharmacies often combine two or more agents to differentiate their products from the commercial or branded version. However, combining Semaglutide with B12 is highly beneficial for various reasons. B12 is essential for metabolism, fat burning, energy, and nerve function. The majority of Americans have low or suboptimal levels. A large segment of this population has gastrointestinal conditions that prevent optimal dietary or oral supplemental B12 absorption, which is why so many people have to get their B12 shots weekly. Accordingly, combining B12 with Semaglutide not only optimizes B12 levels but also amplifies Semaglutide's efficacy in weight reduction. You would no longer need to take B12 supplements while you are on this combination.
  • What is the cost of Semaglutide?
    Check out our competitive prices below! There are low, moderate, high, and maximum doses. The monthly cost of a low dose (0.5 mg weekly) is $250. The monthly cost of a moderate dose (1.25 mg weekly) is $250. The monthly cost of a high dose (2 mg weekly) is $350. The monthly cost of a maximum dose (2.5 mg weekly) is $350. But it gets better! We offer a 10% discount for a 3-month supply! You would save $75 on the low and moderate doses and $105 on the high and maximum doses, so please take advantage of it. We are so excited that California patients now have an affordable and legal option preventing costs from hindering their health goals. 😀
  • I still have questions!
    If you have any other questions, call/text us at 949-229-5257 or info@nhvitality.com.
  • What is women’s Hormone Replacement Therapy (HRT)?
    As a woman gets older, her sex hormones decrease. Counter to popular belief, this happens before menopause; it begins in perimenopause, which itself could start ten years before menopause! That is ten years of low sex hormone levels! So, if a woman goes into menopause at age 50, she may have been in perimenopause since the age of 40! Many breast cancer survivors who are younger than 40 become sex hormone deficient after chemotherapy. The most important sex hormone in a woman is Estrogen; the purpose of women’s HRT is to replace the low Estrogen.
  • So, what if estrogen goes down with age? Why is that a problem?
    Estrogen deficiency has profound effects on a woman’s mind and body. In the same way, Testosterone deficiency has profound effects on a man’s mind and body. Low Estrogen is associated with: Higher risk of colon cancer. Higher risk of heart attacks and strokes. Higher LDL “bad cholesterol.” Diabetes and prediabetes. Unflattering body fat redistribution. Low sex drive. Vaginal atrophy. Labia minora atrophy. Clitoral phimosis. Frequent urinary tract infections. Dyspareunia (painful sexual intercourse). Cognitive decline AKA “brain fog” in 60% of peri and post-menopausal women. Low energy. Thinning hair. Osteoporosis/osteoporotic fractures: Due to both low mineralization and low elasticity of bone, secondary to chronic Estrogen deficiency. Worse prognosis at any stage of breast cancer. Decrease skin thickness and elasticity. Depression. In today’s world, women face the same challenges and corporate pressures as men. Hormone replacement therapy can serve as a valuable catalyst in fostering women's professional advancement by optimizing their well-being and enhancing their cognitive performance, thereby empowering them to excel in their careers.
  • If the purpose of women’s HRT is to replenish the deficient estrogen, why are women on HRT taking hormones such as progesterone and testosterone?
    A woman of reproductive age makes estrogen and progesterone, a hormone that prevents the uterus from being overstimulated by estrogen, which would raise the risk of uterine cancer. Women who are on HRT but don’t have a uterus don’t need progesterone. Testosterone (man’s primary sex hormone) is the parent molecule of estrogen. So, if a woman has estrogen, she must also have testosterone. By the same token, if a woman is no longer making enough estrogen--due to perimenopause or menopause--then she must also be no longer producing enough testosterone. Both men and women need an optimal level of both testosterone and estrogen. The role of testosterone in a woman’s body is very similar to that in a man; it increases libido, lean mass, energy, and, yes, clitoral erectile function! Lean mass is very important for aging women, especially if they have incontinence due to pelvic muscle atrophy from multiple pregnancies or other causes.
  • If women’s HRT is that important, why are most peri/post-menopausal women NOT on it?
    The reason behind that is that most women and most doctors associate estrogen with blood clots and breast cancer; a few decades ago, a couple of extensive studies showed an association between estrogen and these two diseases; the quality of these studies is questionable, but more importantly, the women in these studies were NOT on estrogen that is identical to that of humans; they were on horse-derived estrogen. In today's world, we no longer prescribe equine estrogen because we have bioidentical estrogen, the same molecule that a woman's body produces.
  • So, what causes blood clots in women?
    The same things that cause clots in men: Smoking, a sedentary lifestyle, diabetes, high blood pressure, stress, bad cholesterol, and estrogen deficiency!
  • What causes breast cancer in a woman?
    We have no idea! Breast cancer is the most common cancer in the world, and every woman has a high likelihood of developing it. Indeed, there seems to be an association between breast cancer and estrogen, but it looks like a protective one; leading breast cancer, oncologists report a better prognosis at any stage of breast cancer if a woman is on HRT.
  • So, if estrogen is so important, then why are most peri and post-menopausal women NOT on HRT?
    Indeed, in the 1970s, 70% of peri and post-menopausal women were on HRT. Now, only 5% are on it! This is because of a large study (The Women’s Health Initiative study) that showed an association between women’s HRT and breast cancer 20 years ago. Since then, many leading physicians—yes, including breast cancer oncologists—have denounced the study, not just because the methods of the study were flawed, but also because women in that study did NOT use bioidentical hormones. They were on horse-derived estrogen and a synthetic type of progestin, which we NEVER use these days, especially with the availability of affordable bioidentical hormones. Despite this, the breast cancer misinformation persists. Estrogen does NOT cause breast cancer; in fact, the prognosis after a diagnosis of breast cancer is better at every cancer stage if a woman is on HRT! There are 80- and 90-year-old women on oral estrogen, and they are thriving. We don’t know what causes breast cancer. Alcohol, obesity, and smoking increase the risk of breast cancer. Breast cancer is the most common cancer worldwide; every woman (regardless of her estrogen levels) has a 1/8 chance of developing breast cancer in her lifetime. It is why mammograms exist!
  • Can every estrogen-deficient woman be on HRT?
    Unless you have active breast cancer, there is no absolute contraindication to HRT. However, a risk and benefit analysis is a conversation that every woman should have with her physician with regard to any treatment, not just HRT.
  • I am a 65-year-old woman who has been post-menopausal for 15 years; I am interested in HRT, but my gynecologist did not recommend it because it’s been more than ten years since I went through menopause. Can a woman start HRT if it’s been over ten years since menopause?
    So, where does this 10-year cut-off window come from? Why is it not 9 or 11? That's because women's HRT studies have not been conducted on women who start HRT after ten years of menopause, so the safety of HRT in this population is unknown. "Unknown" is NOT equal to unsafe; it just means that a prudent, knowledgeable physician must weigh the risks and benefits of HRT in every woman, regardless of age. For instance, a woman who had just become menopausal at 50 and who is diabetic and smokes cigarettes is at a higher risk of developing a heart attack than a 65-year-old woman who has been in menopause for over 15 years and is healthy and not on any medication; so in this case, HRT is safe to start on the 65-year-old woman but not safe to start on the 50-year-old. Does that make sense? Because today's doctors sadly focus on a one-size-fits-all approach as they see 30 patients a day and must minimize liability, they no longer take every woman on a case-by-case basis. Every woman is different, and that must be taken into consideration.
  • I have a mutated BRCA gene; can I go on HRT?
    Yes! Women with inherited mutant variants in breast cancer type 1 and 2 susceptibility genes (BRCA1/2) have markedly elevated risks of breast and ovarian cancer and must follow up with a gynecologist. In terms of breast cancer, women with a BRCA1/2 pathogenic variant may opt for bilateral mastectomy (breast removal). Otherwise, they may opt for annual mammography and magnetic resonance imaging (MRI) starting at age 25 unless they are BRCA2 mutation carriers, as they would need to be on a selective estrogen receptor modulator (SERM), such as tamoxifen or an aromatase inhibitor such as anastrozole. In terms of ovarian cancer, they may opt for removal of the ovaries after the age of 35 after childbearing is complete. Otherwise, we recommend ovarian cancer screening with regular labs (CA 125) and transvaginal ultrasound. Current research indicates that estrogen replacement therapy does not seem to have a relevant effect on cancer risk in BRCA mutation carriers.
  • Why don't you offer pellets?
    Although we understand the appeal of "set it and forget it," we vehemently recommend AGAINST hormonal pellets for men or women for two main reasons. Hormone replacement therapy (HRT) is never a "set it and forget" treatment plan. With time, our bodies change, our needs change, and our hormone receptor density changes. Therefore, it is imperative to use HRT routes that permit timely dose adjustment, which is not possible with pellets. On pellets, people seem to be either underdosed or overdosed. More importantly, the incidence of breast cancer is high in women, and it increases with age, regardless of hormonal status. Estrogen does not cause breast cancer. We don't know the cause of breast cancer. However, should breast cancer be diagnosed while a woman is on HRT, we have to be able to stop HRT as soon as possible; so if you have pellets, how are they going to locate each one of these pellets and remove them timely?
  • What medicines do you prescribe as part of your women’s HRT programs?
    We prescribe systemic estrogen, progesterone, and testosterone. All are available orally and topically. We also prescribe, and prefer, injectable estradiol and testosterone.
  • I am in my 40s and I am on birth control. Should I be on hormone replacement therapy (HRT)?
    So you're in your 40s and on birth control. Now what? You are most likely perimenopausal, which is the equivalent of being hypogonadal (you have a deficiency of at least one of your sex hormones). If you are sure that you don't want children in the future, I recommend sterilization (tubal ligation). If you are not sure about it or you don't want to get off birth control, I recommend the following: If you are on a progestin-only method, you will need to be tested for estrogen and testosterone deficiency and treated accordingly. If you are on a combined method, you will need to be assessed for testosterone deficiency and be treated accordingly. To get a better understanding of my recommendations, continue reading about hormonal birth control below: Birth control methods include intrauterine devices (IUDs), pills, rings, and implants. They may be physical barriers such as copper IUDs or hormonal barriers. Hormonal barriers may be progestin-only or combined estrogen and progestin. I understand the importance of birth control and family planning. But the truth is, up to this day, besides the timing of sex and access to early medical abortion, there are no ideal birth control methods. For women who have no desire to have children, sterilization (tubal ligation) is the optimal method. IUDs are foreign bodies, and as such, they cause a hyperinflammatory state in the uterus. Hormonal methods work by suppressing a woman's ovary. When the ovary is suppressed, it does not work, so there is no ovulation and hence no pregnancy. But what's the job of the ovary? Sadly, ovaries are almost always discussed in the context of reproduction and pregnancy. This is a shame because it paints women as reproductive machines, with nary a mention of the actual primary function of the ovary: It is the woman's sex hormone production machine! The ovary's function is testosterone and progesterone production and the subsequent conversion of testosterone to estradiol, a woman's most active version of estrogen. Women need testosterone as much as men and for the same reasons men need it. Women also need testosterone because it is the main source of their estrogen. When women discuss combined hormonal birth control with their doctor, it's imperative to discuss the effect of birth control on endogenous testosterone production. When discussing progestin-only methods, endogenous testosterone and estrogen should also be discussed. In summary, women need to understand that they need three sex hormones: Testosterone, Estradiol, and Progesterone (if they have a uterus)! Progestin-only methods cause severe deficiency in testosterone and estradiol, causing an infinite number of physical and emotional ailments. Combined hormone methods also cause severe testosterone deficiency, which also causes physical and psychological disorders. Women, like men, are testosterone-reliant. In a eugonadal (normal sex hormone levels) healthy woman who is not on birth control, physiologic testosterone levels are at least 1000 more than estrogen, indicating the biological fact that women, like men, need a predominance of testosterone in their bodies. For instance, many women on birth control complain of weight gain, which makes perfect sense because they are usually testosterone deficient, which slows metabolism, causing weight gain. Women's health has unfortunately been regressing in this country for the last few decades. I am not just referring to the reversal of Roe V Wade and the stigma and misinformation surrounding women's HRT and medical abortion. Consider the recent introduction of an over-the-counter daily progestin-only birth control pill named Opill! This pill is bound to cause estrogen and testosterone deficiency, both of which have a negative impact on physical and mental health.
  • I am a woman who is only interested in getting on Testosterone. Can I do that?
    Generally we do not recommend that because unopposed Testosterone tends to cause acne and excessive hair growth. However, we may opt for this strategy on a case by case basis after careful assessment of risks and benefits.
  • Can I use my HSA/FSA/HRA account/card to pay my fees at Newport Health & Vitality?
    It is on a Case-by-case basis. You would have to try and see. We'll help you as much as we can.
  • My friend is on hormone replacement therapy (HRT), and she told me that she does not feel any better. So, are there benefits to getting on HRT? And if so, why is my friend not feeling better?
    This is common, and the cause is always the same: Ineffective HRT! Ineffective HRT occurs when hormones are prescribed without adequate monitoring and dose adjustment. These patients are almost always under-dosed, a pattern that is the hallmark of HRT through insurance-based clinics and clinics manned by unqualified health workers. The route and dose of hormones need to be patient-specific, and blood levels must be monitored regularly. I cannot tell you how many women are on inappropriate doses of estradiol, progesterone, testosterone, and thyroid hormones! What's the point of HRT if it's ineffective? What's the point of thyroid replacement therapy if it's not weight and lab-based?
  • What are your thoughts on vaginal estrogen creams for post-menopausal vaginal atrophy and dryness?
    I do not prescribe vaginal creams because they are messy and unpleasant, and most importantly, they dont address the main problem: systemic estrogen deficiency. A dry, painful vagina in a post-menopausal woman is not an isolated disease; it's a sign of an underlying systemic disease due to systemic estrogen deficiency, which is what we need to treat. The vagina, in this case, is a reflection of a woman's overall health. Using a vaginal cream negates this fact.
  • Do you treat women's hypoactive sexual disorders?
    We will first assess the cause of the condition. If we cannot identify factors such as medication side effects, I offer hormone replacement therapy and/or PT-141/Bremelanotide for this condition.
  • My prolactin levels are always higher than normal. I heard that it could be a cause of my low endogenous sex hormone production; I also heard that sex hormones themselves increase it. Do you treat that?
    The upper limit of prolactin for men is 20 ng/ml. The upper limit of prolactin for women is 30 ng/ml. The concern of elevated prolactin is that it may be from a benign tumor in the brain that is overproducing prolactin and exerting pressure injury to nearby structures of the brain. Additionally, prolactin levels at a certain point may reduce the endogenous production of sex hormones or cause gynecomastia and nipple discharge. A large tumor, even if benign, may cause headaches and visual disturbances, at which point we'd refer for surgical removal of the tumor. If the tumor is large, prolactin levels are usually over 200 ng/ml. If the tumor is small, levels are below 200 ng/ml. Small tumors are treated medically and monitored by serial prolactin measurements. Most of them don't change over time or regress. It's quite rare to detect symptoms and signs of hypogonadism or chest symptoms, such as nipple discharge when prolactin levels are under 50 ng/ml. However, the vast majority of the time, prolactin elevation is not from a tumor. It's idiopathic, which means that the cause is unknown, and it's clinically insignificant and does not warrant any treatment; idiopathic hyperprolactinemia may increase levels up to 100 ng/ml. Alternatively, it's from an identifiable cause, such as elevated estradiol levels, stress, and certain psychoactive medications. For instance, in both men and women, supraphsiologic levels of estradiol may increase prolactin. We see that in women who are pregnant with circulating estradiol levels in the 100s or 1000 pg/ml. We see it in men who are on TRT but not controlling their estradiol levels. We also see it in transwomen. Also, remember that stress alone—due to increased cortisol (stress hormone) production—may increase prolactin by 20 ng/ml on top of normal levels. It's not uncommon to see levels in the 40s ng/ml in patients undergoing a stressful period in their lives. Nipple stimulation also increases prolactin. Moreover, commonly prescribed psychiatric medications such as Prozac and Lexapro can very well increase prolactin to up to 100 ng/ml at the usual dose of these medications. That's why I always try to guide my patients through a "weaning" process to get off of these psychiatric medications. Antipsychotics like risperidone may increase levels to 300 ng/ml. Our lab panel includes prolactin, so rest assured we would not miss a tumor.
  • Do you diagnose and treat polycystic ovary syndrome (PCOS)?
    Yes!
  • What are your thoughts on birth control?
    Birth control methods include intrauterine devices (IUDs), pills, rings, and implants. They may be physical barriers such as copper IUDs or hormonal barriers. Hormonal barriers may be progestin-only or combined estrogen and progestin. I understand the importance of birth control and family planning. But the truth is, up to this day, besides the timing of sex and access to early medical abortion, there are no ideal birth control methods. For women who have no desire to have children, sterilization (tubal ligation) is the optimal method. IUDs are foreign bodies, and as such, they cause a hyperinflammatory state in the uterus or excessive bleeding and iron deficiency. Hormonal methods work by suppressing a woman's ovary. When the ovary is suppressed, it does not work, so there is no ovulation and hence no pregnancy. But what's the job of the ovary? Sadly, ovaries are almost always discussed in the context of reproduction and pregnancy. This is a shame because it paints women as reproductive machines, with nary a mention of the actual primary function of the ovary: It is the woman's sex hormone production machine! The ovary's function is testosterone and progesterone production and the subsequent conversion of testosterone to estradiol, a woman's most active version of estrogen. Women need testosterone as much as men and for the same reasons men need it. Women also need testosterone because it is the main source of their estrogen. When women discuss combined hormonal birth control with their doctor, it's imperative to discuss the effect of birth control on endogenous testosterone production. When discussing progestin-only methods, endogenous testosterone and estrogen should also be discussed. In summary, women need to understand that they need three sex hormones: Testosterone, Estradiol, and Progesterone (if they have a uterus)! Progestin-only methods cause severe deficiency in testosterone and estradiol, causing an infinite number of physical and emotional ailments. Combined hormone methods also cause severe testosterone deficiency, which also causes physical and psychological disorders. Women, like men, are testosterone-reliant. In a eugonadal (physiologic normal sex hormone levels) healthy woman who is not on birth control, physiologic testosterone levels are at least 1000 more than estrogen, indicating the biological fact that women, like men, need a predominance of testosterone in their bodies. For instance, many women on birth control complain of weight gain, which makes perfect sense because they are usually testosterone deficient, which slows metabolism, causing weight gain. Women's health has unfortunately been regressing in this country for the last few decades. I am not just referring to the reversal of Roe V Wade and the stigma and misinformation surrounding women's HRT and medical abortion. Consider the recent introduction of an over-the-counter daily progestin-only birth control pill named Opill! Not only is this pill bound to cause estrogen and testosterone deficiency, but to sell a daily hormone over the counter is potentially harmful. Timing of sex is a great way to avoid unplanned pregnancy, as well as plan B, which is available over the counter. Men's condoms are usually undesirable and "pull out" method is unreliable, but both are birth control methods as well. Once you stop birth control pills, your period returns, at which point, you can use the following method to time unprotected sex: This method works best if your cycles are usually between 26 and 32 days long. Count the days in your menstrual cycle, starting with the first day of your period as day 1. Continue counting each day of your cycle until your next cycle starts. On days 1-7, you can have unprotected sex, but you may have menstrual bleeding on those days. On day 20 through the end of your cycle, you can have sex. When you get your next period, start counting as day 1. To help track your cycle, you may use a tool such as CycleBeads: https://www.cyclebeads.com/ CycleBeads has an app for monitoring cycle days.
  • Do you treat gender dysphoria in women? I am a woman who wants to become a man.
    Yes, I am happy to help you in your journey.
  • Given the possible side effects, the cost, and regular follow-up requirements, is Hormone Replacement Therapy (HRT) worth it?
    If HRT were not worth it, many women would not take it. The dramatic benefits outweigh the costs, risks, and upkeep. With a doctor-managed HRT program, women who would otherwise not have gone to the doctor get their health assessed periodically, which ensures preventive care and early detection and treatment of cancer and metabolic disease.
  • Should I drink "protein shakes?"
    The most challenging aspect of health, fitness, and bodybuilding is ensuring adequate animal protein intake daily. We, therefore, understand the appeal and convenience of "protein shakes." But we can't tell if protein exists in the "shake." "protein shakes" are considered a "dietary supplement" by the FDA, meaning they are not regulated to the extent that food or medicines are. Manufacturers are responsible for ensuring that their products are not harmful, though many companies do not test for safety or efficacy before marketing them. The FDA created Good Manufacturing Practices (GMPs) to help minimize adverse issues, but compliance with these procedures remains a concern. In 2017, about a quarter of supplement-manufacturing companies whose products were tested received citations related to purity, strength, and ingredient content. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 1990s. These supplements also contain irritants that can affect your intestine's ability to absorb nutrients and cause irritable bowel syndrome. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by laboratory methods.
  • I heard that Hormone Replacement Therapy (HRT) in women may cause vaginal (uterine) spotting or bleeding. Is that true, and if it is, would it be a valid reason to avoid HRT?
    Most women who go on HRT will not experience this side effect. However, some women will experience painless spotting or bleeding resembling menstruation. While we don't know the exact mechanisms behind it, if it's happening after starting HRT, then it's most likely related to HRT. Specifically, it must be associated with the specific dose/strength of each component of the HRT regimen. There is no one-size-fits-all regarding women's HRT because every woman is unique. Therefore, determining the correct dose and combination takes time and skill; it takes at least six months to optimize a woman's HRT regimen, and it is during this time that vaginal (uterine) spotting or bleeding usually takes place, and it's benign. With proper hormone monitoring and effective communication between the doctor, HRT benefits outweigh the risks, and your doctor will know when it's time for a gynecologic or transvaginal ultrasound referral.
  • Should I take Tongkat Ali?
    Tongkat Ali--AKA Longjack--is a plant root extract used in Eastern medicine, specifically in Malaysia. Only a little research has been done on humans; the long-term effects are unknown. Still, from the few human trials, this root extract has been identified as a peptide of 32 amino acids that improves sexual function, decreases stress, increases free testosterone, and decreases cortisol (the primary stress hormone); the mechanism by which it does this remains unknown. The required daily dose of the extract is 200-400 mg. But here is why you should not purchase Tongkat Ali. A patent has been issued jointly to the Government of Malaysia and the Massachusetts Institute of Technology for extracting the peptide from the plant's root; all the research on humans and animals showing positive effects is done on Tongkat that is extracted via that patented method. This means that the grand majority—if not all—of the products on the market are fake. The plant does not grow in many regions, and it's impossible to ascertain the source of the plants used in the supplements. The active ingredient is a peptide, so it's impossible to guarantee effectiveness if it is not stored in a sterile vial. The exact ingredients and their quantity in the marketed supplements are unknown. Sometimes, they include ground-up generic Viagra and Cialis in these supplements; you're better off getting generic Viagra or Cialis if that's what you want. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 1990s. These supplements also contain irritants that can affect your intestine's ability to absorb nutrients and cause irritable bowel syndrome. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by validated laboratory methods.
  • Do you prescribe or recommend DHEA?
    Dehydroepiandrosterone (DHEA), AKA androstenolone, is often prescribed orally as part of a woman's hormone replacement regimen. It is a very weak androgen and, therefore, ineffective. Reports on its efficacy on social media are anecdotal and inconsistent. Chiropractors and naturopaths love it. It is also an unregulated supplement, which means that the long-term risk of IBS and colon cancer remains unknown. Why take DHEA when there is readily available testosterone? Testosterone is an essential component of a woman's HRT regimen, and lucky for women, they can take it orally, topically, and by injection. Save your money and protect your gut!
  • Should I take creatine supplementation?
    No! Your cells are capable of assessing their creatine needs and producing creatine accordingly. We are aware of the creatine supplements sold on social media. However, the research on creatine is low-quality, inconclusive, and sparse. Please remember that over-the-counter supplements are not harmless. They are unregulated, and the manufacturer does not need to prove efficacy, quality control, or long-term safety. The rate of colon cancer among Americans under the age of 50 has doubled since the late 90s. We recommend against ingesting supplements unless they are specifically recommended by a doctor, for a specific reason, and monitored by laboratory methods.
  • Is your lab panel ("blood work") comprehensive enough? I want "everything checked."
    When it comes to the specialty of hormone replacement, our lab panel is meticulously comprehensive. We don't believe in ordering unnecessary labs just to inflate the price, a practice we know some medspas engage in. As part of our commitment to providing comprehensive service, our lab panel includes all the labs your primary care physician would ever need. This means you can complete all necessary tests in one place, saving you time, money, and effort. You can access your labs anytime, anywhere, so you can show them to your primary care physician.
  • I cannot go to the gym or eat healthy because I am too busy with family and work-related issues; my life is out of control now. Should I stop taking testosterone?
    This logic denotes the misconception that the sole benefit of testosterone is exercise tolerance, motivation, and anabolic gain. I cannot overstate the importance of testosterone in energy, motivation, mood, bone density, and fat burning. If you are enduring a psychosocial stressor—such as a work-related, time-sensitive project, a divorce, or funeral planning—does that mean you should stop taking the medicine that is giving you energy, a positive mood, and faster metabolism?! Do stressed-out people not need a mood and energy booster?! Do people who don't go to the gym not need a medicine that boosts their metabolism?! Stress causes the body to produce a lot of cortisol, the principal stress hormone. Cortisol is a catabolic hormone that breaks down muscles; it also raises insulin levels, increasing midsection fat. When you're stressed out, you're not just not building muscle; you're actively breaking it down and depositing fat in your midsection simultaneously! Testosterone counters these effects; it prevents the binding of cortisol to its receptor in the muscle, protecting it from breaking down. Testosterone lowers insulin levels, preventing midsection adiposity. So please don't stop taking your testosterone when you're stressed out or when you're not going to the gym. If anything, that's when you need testosterone more than ever.
  • I don’t live in California. Can we do telemedicine?
    I am licensed to practice medicine only in California. Therefore, physical evaluations must be at my office in California. If you live outside California, I can still help you once we discuss how often you would need to be seen at my office. Many patients see me two times a year but live in a different state. We can arrange for blood draws and get medicines shipped to every state.
  • How long does it take for lab results to come back? What is the blood work turnaround time?
    To ensure that our treatment plan is effective and safe, we include a comprehensive laboratory panel that exceeds the standards of hormone replacement therapy and primary care. Furthermore, we only use the most accurate methodologies for our hormone testing, such as Chromatography combined with Mass Spectrometry. For these reasons, getting the results takes up to 10 business days. For convenience, you can use our mobile phlebotomy service, get your blood drawn at home or the workplace, and then review lab results with Dr. Abdullah via telephone.
  • How much protein should I consume?
    Aim for a daily intake of 1.5 grams of animal protein per current body weight in pounds. But if you are trying to increase lean mass, you need 3 grams daily. Animal protein includes meats, milk, and eggs.
  • How do I dispose of used needles and sharps?
    Please purchase a sharps and biohazard disposal container from our office or from Amazon. Once the container is filled, you can take it to a local sharps and biohazard disposal facility. If you live in Orange county, see location description below. If you live in another county please go to: https://calrecycle.ca.gov/epr/pharmasharps/sharps/ Orange county residents: Irvine Household Hazardous Waste Collection Center, 6411 Oak Canyon, Irvine, CA 92618. Hours: Tues-sat 9 AM-3 PM. Limit to disposal: 125 pounds per trip.
  • I still have questions!
    If you have any other questions, call/text us at 949-229-5257 or info@nhvitality.com.
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