by Family Physicians
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by Family Physicians
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Many patients have asked why I dismissed testosterone replacement for my patients during the last quarter century of my career but now offer it in our clinic at Family Physicians of Cedar Rapids.
My answer is that I had a Galileo moment. Galileo studied astronomy among other sciences around 1600 and had been taught that the earth was the center of the solar system. His observations of the planets did not support traditional theory, and he was one of the astronomers of the era that gave us our current understanding of planetary movement with the sun at the center of the solar system. Over the past couple years, about a dozen of my patients admitted to going to testosterone replacement clinics that are offered elsewhere in town, claiming that they felt like they were back in their 20s. The current FDA position which was taught when I was in medical school at the University of Iowa disputes the claims of my patients and recommends that providers reassure aging adults of both genders that testosterone replacement does not work and to accept low testosterone symptoms as the consequence of aging. Therefore, my classical teaching and current FDA guidance for providers conflicted with 100% of my patients’ testimonies, so I needed to choose who was misleading me. Of course, I believe my own eyes and the testimony of my long-term patients. Around that same time, Jennifer Forkner, ARNP, who is the other provider in our clinic, expressed interest in offering testosterone replacement for our patients. Therefore, I put effort into researching the risks and benefits of testosterone replacement and found that with the exception of men with prostate cancer, the risks that I had been taught were unproven in poor quality studies. The only complaint I received from the patients receiving treatment elsewhere was that the weekly injections caused a seesaw effect with feeling benefit immediately after a weekly injection followed by low testosterone symptoms returning as they came closer to the next injection. Rather than weekly injections that are inconvenient and give the seesaw effect, we chose to use pellets provided by Biote which are natural and can be given every 3 to 6 months. Think of pellets as after dinner mints that slowly dissolve, but rather than take them orally, we insert the pellets under the skin where they dissolve over months. I encourage patients to check a hormone level so that they can take charge of testosterone replacement decisions rather than assume it is something that needs to be accepted as a part of aging. Each patient should choose what they do to alleviate symptoms of aging rather than simply have the medical establishment and government tell them to live with it. An example is that we prescribe little blue pills for men with ED frequently, and using the faulty testosterone logic, we should simply tell them that they need to live with that problem of aging. My Galileo moment is why we now offer testosterone replacement for both men and women managed by Jennifer Forkner, ARNP, with about half of our testosterone replacement patients being women.
Why can’t I just take a pill instead of injections? Some GLP-1 medications do come in pill form, but when swallowed, much of the medicine is broken down in the stomach and liver. This means the pill versions are only strong enough to match the lowest doses of the injectable medications, not the doses needed for real weight loss. Do oral GLP-1s work for weight loss? They can help slightly with appetite, but they are not strong enough for significant or long-term weight loss. There is currently no oral version that works like the full-dose weight-loss injections. What about sublingual (under-the-tongue) GLP-1s? Sublingual GLP-1s dissolve under the tongue and bypass the stomach, allowing better absorption. However, even these reach only lower dose levels and are best for weight maintenance or mild appetite control, not major weight loss. Which option works best for weight loss? Injectable GLP-1 medications provide the strongest appetite control […]
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We gathered together around the table as a doctor’s office family, sharing food, laughter, stories, and the simple joy of being together outside of our busy days caring for others. Moments like these remind us how special it is to be part of a team that truly supports one another. How perfect that today is National Pharmacist Appreciation Day, a day to recognize the incredible pharmacists who work hand-in-hand with our providers to keep our patients safe, informed, and healthy. From carefully checking medications to offering guidance and reassurance, pharmacists are a vital part of every healing journey. We are so thankful for the partnerships we share, the dedication behind the scenes, and the compassionate professionals who make quality care possible. Here’s to teamwork, gratitude, and the people who make medicine more personal every single day.
We are so grateful for the incredible people who make our office feel like family. These moments of laughter, connection, and sharing a meal together remind us why what we do matters, and who we get to do it with. As we gather together again this evening, we’re also stepping into all the exciting things waiting for us in 2026, new goals, new growth, and new memories we’ll create side by side. Cheers to friendship, teamwork, and a future full of great things.
Choosing a vasectomy is a personal decision, and we believe it should come with clear information, comfort, and trust. At our office, vasectomies are performed right here in a familiar medical setting by a doctor you can truly trust, someone who takes the time to listen, answer questions, and make sure you feel confident every step of the way. A vasectomy is a quick, minimally invasive procedure designed to provide long-term birth control. Most appointments are brief, recovery is typically straightforward, and many patients return to normal activities within a few days. Our doctor uses gentle, proven techniques and explains the process clearly, so there are no surprises. What truly sets our office apart is our approach to care. From your first conversation to your follow-up visit, your questions are always welcome. Our doctor uses the no scalpel technique and explains the process clearly, so there are no surprises. If your family […]
