Most clinics hand you a number and a vial. Dr. Haley Moran starts with a harder question: why did your testosterone fall in the first place? For men across West Hollywood and Los Angeles, the answer often changes the whole protocol, and keeps you off lifelong injections far longer than you expected.
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Testosterone falls for reasons. Poor sleep. Chronic stress and high cortisol. Gut dysfunction. Nutrient depletion. Extra body fat that converts testosterone into estrogen. Each cause has a different fix. Replacing the hormone without finding the cause treats the gauge, not the engine.
Dr. Haley Moran leads the testosterone program at Citrin Longevity, and her first move is rarely a vial. Where your own production can be restarted, she uses targeted support like Clomid or enclomiphene to wake up the pituitary signal instead of overriding it. For younger men, and for any man who still wants children, that difference matters. Standard injections suppress the fertility signal. Her approach is built to protect it.
A serum testosterone result is one snapshot of total hormone in the blood. It does not show how much is actually available to your tissues, how much is converting into the active metabolite that powers energy, drive, and recovery, or how much is turning into estrogen instead.
The DUTCH test reads how your body processes hormones, not just how much it makes. It maps more than 35 hormone metabolites. Two men with the same serum number can look completely different underneath. One converts toward the active 5-alpha pathway. The other converts toward the weaker 5-beta pathway, or runs estrogen high. Same number. Different men. Different protocols.
Dr. Moran reads those patterns against your full panel inside our biometric platform, then tracks every change over time. The precision of what we find sets the precision of what we treat.
After 30, untreated testosterone slips about one percent a year. That is the red path. A doctor-led protocol aims to keep you in the optimal range instead. That is the green path. Where you land depends on the testing, the cause, and the plan.
Illustrative trajectories for total testosterone, not population averages or a guarantee. Individual results vary, and a single number is not a diagnosis. We read your own labs and metabolite profile, then set your target with your doctor.
Women make testosterone too, in the ovaries and adrenal glands, and levels fall through perimenopause and menopause. Low testosterone in women shows up as fatigue, low libido, brain fog, mood swings, and workouts that stop paying off.
Dr. Moran built her clinical focus around women's hormones. She assesses testosterone as part of a full female panel and treats it with low, bioidentical doses, often alongside bioidentical estrogen and progesterone (BHRT) for women in perimenopause and menopause. The same DUTCH metabolite analysis guides every dose.
"I do not chase one number for every man. I read where your energy, recovery, and metabolites line up, then we set a target your body can actually hold. Optimal is the level where you function like yourself again, confirmed by the labs."
Dr. Haley Moran, ND. Clinical Director, Citrin Longevity. Targets are individual, set from your metabolite profile and symptoms, not population averages.
Every step is sequenced. Root cause first. Replacement only when it is the right tool. Monitoring the whole way.
Dr. Moran takes a complete history and lifestyle review, then orders a deep blood panel and the DUTCH test: total and free testosterone, metabolite pathways, LH and FSH, estrogen, thyroid, and adrenal function. The full picture comes before any recommendation.
Your results are read against your full hormonal and metabolic profile in our biometric platform. Dr. Moran identifies the real driver, whether that is sleep, cortisol, gut function, body composition, or true testicular decline, and designs around it. The protocol addresses the driver, not just the output.
When your own production can be restarted, Clomid or enclomiphene is used to stimulate the pituitary axis. This protects fertility, keeps your own system working, and avoids lifelong dependence on injections. Most men notice measurable change within 6 to 8 weeks.
Will TRT affect my fertility?
Standard testosterone injections suppress LH and FSH, the pituitary signals that drive sperm production. For men who want to keep their fertility, Dr. Moran uses Clomid or enclomiphene to stimulate your own production instead. This keeps the pituitary axis working and avoids the shutdown that makes coming off injections difficult later. Fertility is part of the first intake conversation, not an afterthought.
What is the difference between total and free testosterone?
Most of the testosterone in your blood is bound to proteins, mainly SHBG, and is unavailable to your tissues. Free testosterone is the unbound fraction that can actually enter cells and drive energy, libido, muscle response, and focus. A man can have adequate total testosterone but very low free testosterone, which is why symptoms persist despite a "normal" reading. We measure both.
How is this different from other TRT clinics in Los Angeles?
Most clinics across Los Angeles and West Hollywood work from a single testosterone number and move straight to injections. We start with the cause. Dr. Moran reads your hormone metabolites with the DUTCH test, protects fertility where it matters, and keeps your protocol inside a full longevity program rather than a standalone prescription. A doctor leads every plan, start to finish.
Is testosterone therapy safe, and what do you monitor?
Handled carefully, hormone therapy is well established, and we treat it as real medicine with real follow-up. Alongside your hormones we watch hematocrit, estrogen, PSA where appropriate, blood pressure, and metabolic markers, and we adjust as your labs change. You will understand the trade-offs before you start. We would rather restart your own production than keep you on a therapy you do not need.
Do you treat women with testosterone?
Yes. Women produce testosterone in the ovaries and adrenal glands, and low levels are linked to fatigue, low libido, mood changes, and poor exercise response. Dr. Moran assesses testosterone as part of a full female hormone panel and treats it with much lower, bioidentical doses than male protocols. For women in perimenopause and menopause, this often pairs with bioidentical estrogen and progesterone (BHRT), guided by the same DUTCH metabolite analysis.
How long does it take to feel a difference?
With natural stimulation using Clomid or enclomiphene, most men notice energy and mood changes within 4 to 6 weeks as their own production rises. With direct replacement, energy and focus often shift within 2 to 3 weeks. Body composition changes usually take 8 to 16 weeks of steady levels. The 12-week retest documents what the data shows, not just what you feel.
Injections, cream, gel, or pellets: which form is best?
There is no single best form. Injections are precise and easy to adjust. Daily cream or gel runs steadier and avoids needles, but it can transfer to a partner or child through skin contact. Pellets last months but cannot be dialed back once placed. Dr. Moran matches the delivery method to your labs, your goals, and your life, then adjusts as your metabolite profile changes.
What is the difference between enclomiphene and Clomid?
Both are pills that signal your pituitary to make more of your own testosterone, instead of replacing it from outside. Clomid (clomiphene) is a mix of two isomers, and the extra one can raise estrogen and affect mood in some men. Enclomiphene is the cleaner single isomer, often with fewer of those effects. Dr. Moran chooses between them based on your DUTCH results and how you respond.
Do I need hCG on testosterone therapy?
Standard testosterone shuts down the signal that keeps your testicles active, which can shrink them and lower sperm count. hCG mimics that signal and keeps them working, which is why it is often added for men who want to preserve fertility or testicular size. It is not automatic. Dr. Moran decides based on your goals, your labs, and whether a stimulation-first approach fits you better.
Will I need an estrogen blocker like anastrozole?
Not by default. Some testosterone converts to estradiol, and men need a healthy amount of it for libido, mood, joints, and bone. Pushing estrogen too low with a blocker can make you feel worse. Dr. Moran often manages estradiol through dose and frequency first, and only considers anastrozole when the metabolite data and symptoms genuinely call for it.
Does TRT cause thick blood, and will I have to donate blood?
Testosterone can raise hematocrit, the share of red cells in your blood, which is why we watch it on every panel. Often the fix is a dose or frequency adjustment, better hydration, or addressing sleep apnea. If your hematocrit climbs too high, periodic blood donation can bring it down. This is exactly the kind of marker that careful monitoring is meant to catch early.
Does testosterone therapy raise PSA or prostate cancer risk?
Testosterone can stimulate the prostate, which may nudge PSA up or affect urinary flow, so we screen first and track PSA where appropriate. Current evidence has not shown that well-monitored therapy causes prostate cancer in men without it. Dr. Moran reviews your prostate history before you start and coordinates with a urologist when your numbers or symptoms warrant it.
Will TRT make me lose my hair?
Testosterone can convert to DHT, the hormone tied to male pattern hair loss, so therapy may speed up thinning in men already prone to it. The DUTCH test shows how strongly you convert down that pathway, which helps set expectations early. For image-conscious men across West Hollywood and Los Angeles, Dr. Moran factors this in and can discuss options to protect your hairline alongside your protocol.
Can testosterone therapy worsen sleep apnea?
Testosterone may worsen sleep apnea in some men, and untreated apnea can also drive testosterone down in the first place, so the two are linked. That is why your intake includes questions about snoring, daytime fatigue, and sleep quality. If apnea is part of your picture, Dr. Moran addresses it as a root cause rather than dosing around it.
Is an online TRT service as good as an in-person doctor?
Mail-order programs are convenient, but many run on a single lab value, light monitoring, and little follow-up on hematocrit, estrogen, or PSA. Testosterone is a controlled substance in California and deserves real oversight. At Citrin Longevity in West Hollywood, Dr. Moran leads a 90-minute intake, full metabolite testing, and in-person monitoring, so your protocol is supervised by a doctor who actually tracks your results over time.
Your first visit is 90 minutes with Dr. Moran: a full hormone panel, DUTCH test, body composition, and a protocol built around the cause we find. No generic scripts. No skipping the diagnostics. Serving men and women across West Hollywood and Los Angeles.
