Early weeks
Initiation
If your provider determines you're eligible, treatment begins at a starting dose calibrated to your baseline labs. Many clients report improved sleep and subtle energy changes within the first few weeks.
Testosterone optimization built around your labs.Testosterone Cypionate
Testosterone cypionate is a long-acting injectable form of testosterone, the most commonly prescribed therapy for medically supervised TRT. At Marek, every prescription is preceded by complete labs and reviewed by a partnered licensed medical provider, so eligibility, dose, and monitoring are determined by your data, not a template.
LC/MS-MS
Gold-standard testosterone assay, not the immunoassay most clinics use
80+
Biomarkers tested before medical provider prescription*
All 50
States licensed & HSA/FSA eligible
HSA/FSA eligible · No commitmentHSA/FSA eligible · No commitment
Hormones · TRT
Marketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
Marketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
LC/MS-MS
Gold-standard testosterone assay, not the immunoassay most clinics use
80+
Biomarkers tested before medical provider prescription*
All 50
States licensed & HSA/FSA eligible
Why Testosterone Cypionate
What makes it different.
LC/MS-MS testosterone assay
Free T & Estradiol monitored
Daily-TIW protocols for stable levels
Dedicated health coach
What to expect
Your Testosterone Cypionate timeline.
First few months
Provider-led titration
Your provider may adjust dosing based on tolerability, response, and follow-up labs, including Free T, Estradiol, and hematocrit. Your coach supports you through any changes.
Mid-treatment
Follow-up labs
Repeat labs help your provider evaluate testosterone levels, estradiol balance, hematocrit, and cardiovascular markers. Adjustments are made when warranted.
Ongoing
Long-term monitoring
Ongoing care typically includes labs every 3 to 6 months and monthly coach check-ins. Long-term planning is individualized to your goals and clinical picture.
How it works
From sign-up to treatment.From sign-up to your first dose.
Take the assessment
45-min intake with your dedicated health coach. A free health-score quiz is available before the paid intake.
Get your labs drawn
Complete lab panel ordered by your provider, drawn at any of 4,000 partnered lab locations nationwide. Results typically return within 14 days.
Provider reviews your results
A licensed medical provider reviews your labs and history to evaluate whether Testosterone Cypionate is appropriate for you. Eligibility and any prescription are determined at the provider's discretion.
If eligible, treatment ships to your door
If your provider prescribes Testosterone Cypionate, it ships from a licensed pharmacy. Your coach supports you through follow-up labs and ongoing monitoring.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
The science
How testosterone cypionate works.
Testosterone cypionate is an oil-based, esterified form of testosterone with a half-life of approximately 8 days. The cypionate ester is slowly cleaved by tissue esterases, releasing free testosterone gradually, which is what allows once- or twice-weekly subcutaneous or intramuscular injections to maintain stable serum levels.
Once released, testosterone binds to androgen receptors in muscle, bone, and brain tissue, driving protein synthesis, bone-mineral density, libido, and cognitive function. A portion is also aromatized to estradiol, which is why estradiol management is an integral part of any well-designed TRT protocol.
Because exogenous testosterone suppresses the hypothalamic-pituitary-gonadal axis, endogenous production typically declines on TRT. Some clients pair TRT with HCG or enclomiphene to preserve testicular function or fertility. The TRAVERSE trial (NEJM 2023) is the most recent major cardiovascular safety study.
Considered for: clinically diagnosed hypogonadismPersistent low Free T with symptomsAge-related symptomatic declineConfirmed by repeat morning labs
Eligibility, dosing, and outcomes vary. Any prescription is at the discretion of a partnered licensed medical provider based on your labs and medical history.
Clinical evidence
The research behind Testosterone Cypionate.
TRAVERSE: Cardiovascular safety in men with hypogonadism
New England Journal of Medicine (2023)
5,246 men ages 45 to 80 with hypogonadism and elevated cardiovascular risk. Testosterone replacement was non-inferior to placebo for the primary composite cardiovascular outcome.
Read study →The Testosterone Trials: Effects in older men
New England Journal of Medicine (2016)
790 men age 65+ with low testosterone across seven coordinated trials. Treatment was associated with improvements in sexual function, mood, and walking distance over 12 months.
Read study →Bhasin et al.: Endocrine Society clinical practice guideline
Journal of Clinical Endocrinology & Metabolism (2018)
Reference guideline for diagnosing and treating testosterone deficiency. Recommends confirming low testosterone with two morning measurements before initiating therapy.
Read study →Safety profile
Monitoring & safety information.
Commonly reported side effects
- Acne or oily skin
- Mild fluid retention
- Estradiol fluctuation (managed with monitoring)
- Injection-site soreness or local irritation
Less common but serious risks
- Elevated hematocrit / polycythemia (monitored via follow-up labs)
- Suppression of endogenous sperm production / reduced fertility
- Worsening of untreated obstructive sleep apnea
- Mood changes if estradiol balance is not maintained
Generally not appropriate for
- Active or untreated prostate cancer
- Untreated severe sleep apnea
- Hematocrit above the safe range
- Men actively trying to conceive (without an HCG / enclomiphene strategy)
Typical monitoring
- Total and Free Testosterone
- Estradiol, sensitive
- Hematocrit & hemoglobin
- PSA & lipid panel
FAQ
Quick answers.
Eligibility, dose, and duration are determined by a partnered licensed medical provider based on your complete labs and medical history. A prescription is not guaranteed, your provider may recommend testosterone cypionate, a different therapy (e.g. enclomiphene), or a non-pharmacologic approach.
Persistent fatigue, brain fog, low libido, difficulty building or maintaining muscle, and declining performance, especially in combination, can suggest suboptimal testosterone. Marek's baseline panel measures Total T (LC/MS), Free T, SHBG, and Estradiol (sensitive) among other markers, so your provider can evaluate the full picture rather than a single number.
Commonly reported side effects include acne, mild fluid retention, and injection-site soreness. Less common but serious risks include elevated hematocrit (monitored via follow-up labs), suppression of sperm production, and worsening of untreated sleep apnea.
Exogenous testosterone suppresses the body's natural testosterone production and can reduce sperm production. If fertility is a current or future concern, your provider may discuss strategies such as pairing TRT with HCG or considering enclomiphene as an alternative. These decisions are made by your provider based on your goals and labs.
Most TRT clinics measure total testosterone and prescribe a template dose. Marek's baseline panel includes 80+ biomarkers, Total T via LC/MS, Free T, SHBG, Estradiol (sensitive), hematocrit, lipids, and metabolic markers, and a dedicated health coach supports you through monthly check-ins. Any prescription is reviewed and managed by a partnered licensed medical provider.
Pricing starts with a $299 intake assessment with your dedicated health coach. Lab pricing starts at $450. If your provider determines a prescription is appropriate, medication cost is separate. Follow-up labs every 3 to 6 months are typical. HSA/FSA eligible.
Dose adjustments are made by your provider based on follow-up labs (Total T, Free T, Estradiol, hematocrit) and how you're feeling, not on a fixed schedule. Your coach helps surface relevant changes between visits so adjustments are informed by real data, not guesswork.
Eligibility, dose, and duration are determined by a partnered licensed medical provider based on your complete labs and medical history. A prescription is not guaranteed, your provider may recommend testosterone cypionate, a different therapy (e.g. enclomiphene), or a non-pharmacologic approach.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.