Fertility
It can lower sperm production. Tell us if you may want children.
Discussed before treatmentTestosterone consultation
Concerned AboutLow Testosterone? We Offer TRT Consultations in Minnesota & North Dakota
Find out if low testosterone may be affecting you—and whether TRT is the right option. We review your symptoms, labs, potential causes, treatment options, risks, and alternatives from the start.
2Early-morning blood tests on separate days, the usual way low testosterone is confirmed
300 ng/dLThe cutoff the American Urological Association treats as reasonable for low total testosterone
4Risks we always talk through: fertility, blood count, sleep apnea and more
HSA/FSAAccepted. Eligibility depends on your plan
Signs and symptoms
What Low T Can Look Like
Possible symptoms and signs of low testosterone (low T), by area. Many of them have other causes too, which is why testing comes first.
| Category | Possible symptoms and signs |
|---|---|
| Sexual health | Reduced sex drive, fewer sexual thoughts, fewer morning or spontaneous erections, difficulty getting or maintaining an erection |
| Energy and stamina | Persistent fatigue, low energy, reduced endurance |
| Muscle and body composition | Loss of muscle mass, reduced strength, increased body fat |
| Mood | Depressed mood, irritability |
| Focus and memory | Difficulty concentrating, forgetfulness, feeling mentally foggy |
| Body hair | Reduced facial or body hair, including underarm and pubic hair |
| Breast changes | Enlarged breast tissue or breast tenderness |
| Testicular and reproductive changes | Smaller testicles, low sperm count, difficulty conceiving |
| Temperature regulation | Hot flashes, particularly when testosterone is very low |
| Bone health | Reduced bone density, osteoporosis, increased susceptibility to fractures |
| Blood counts | Low red blood cell count or anemia, which may contribute to fatigue and weakness (Bone loss, anemia, and low sperm count may only be discovered through testing.) |
Symptoms
Is It Worth Checking?
Check any symptoms you're experiencing to see if low T (low testosterone) is worth following up on. This isn't a diagnosis, and nothing is saved.
Symptom check
Check What Applies
These symptoms are common and have many causes. Low testosterone is diagnosed from symptoms plus blood tests, not from a checklist.
0 checked
Worth Keeping an Eye On
A symptom or two is very common. If it's been going on for weeks and bothers you, a lab check and a conversation can rule things in or out.
- Sleep
- Stress
- Medicines
- Thyroid
- Testosterone
0 checked
Worth a Proper Look
Several of these together are worth discussing. The first step is early-morning blood work, and we'll check the other common causes too, not just testosterone.
- Sleep apnea
- Weight
- Alcohol
- Medicines
- Thyroid
- Low mood
The visit
Answers, Then Options
Click through to see what happens. You leave knowing what your labs mean and what, if anything, comes next.
Your labs
Your Results Explained
Dr. Ewals reviews your blood tests with you: what's in range, what isn't, and what the analysis means for you.
You
The Whole Picture
Your symptoms, medicines, sleep, family plans and other conditions. Some change which options are safe for you.
Options
Including Not Treating
Not treating, treating an underlying cause such as sleep apnea, or testosterone therapy if it's appropriate. Each with its trade-offs explained.
If you both decide
A Plan You Understand
The treatment form, dose, follow-up schedule and labs, written down. You can stop and talk it over at any point.
First steps
Before Your Visit
Check things off as you go. Your list is remembered on this device only.
0 of 3 ready
Risks
The Part Others Skip
Testosterone replacement is a long-term medication with potential side effects. Your provider will discuss the potential impact with you.
Blood Count
It can raise red blood cells (hematocrit), which needs monitoring.
Checked with your repeat labsSleep Apnea
Untreated sleep apnea may get worse.
Discuss with your medical providerOther Effects
Acne, fluid retention, breast tenderness, and skin transfer with gels.
Tell us about any changeProstate and heart health are monitored throughout treatment.
Cost
What It Costs, Up Front
Labs are billed separately by the lab. Fees are non-refundable.
Initial Consultation
$200A comprehensive 45-minute new patient consultation. Questions answered. Options explained. If you start TRT, it covers your first 4-week supply.
$50 deposit to book, balance before your visitAll-Inclusive TRT Membership
$175Testosterone medication, all supplies for home use, shipping, provider access and all follow-up visits with Dr. Ewals. Labs not included.
Every 4 weeks, or $2,000 a year up frontLab Work
Varies by labNot included in the membership. Once your levels are stable (usually 2 to 4 months), labs are recommended every 3 to 6 months.
Paid to the lab
Insurance not accepted
HSA/FSA accepted
Monitoring
Checked, Not Forgotten
If you start treatment, follow-up visits and repeat labs are part of it, typically testosterone level, blood count and, for many men, PSA. What monitoring involves
Before You Start
Baseline labs and a clear plan, so there's something to compare against later.
The Early Months
Labs closer together while your dose settles and any side effects show up.
Once You're Stable
Follow-ups every 8 to 24 weeks with the same clinician, and labs every 3 to 6 months.
Book online
Pick a Time That Works
New or returning? Choose below and book a time straight into Dr. Ewals' calendar.
FAQ
What men ask us about testosterone. Still unsure? Call Will at (218) 274-4500.
See every questionHow much does TRT cost at Alternative Health?
- Initial consultation: $200. If you qualify and decide to start treatment, it includes your first 4-week supply of testosterone, supplies and shipping.
- Every 4 weeks after that: $175, OR
- Pay $2,000 upfront for the whole year and save $300. ($200 consultation fee is credited toward membership, leaving a balance of $1,800)
- Follow-up visits are included in both plans.
- Lab work is billed separately by the lab you choose. (If you don't have a preference, we can refer you to a lab.)
Do I need lab work before a testosterone consultation?
Usually, yes. Call us for a lab order, complete the labs, and then book your visit so Dr. Ewals can review the results with you. Low testosterone is generally confirmed with early-morning blood tests on more than one day, not symptoms alone.
What are the common signs of low testosterone?
Low energy, low libido or weaker erections, losing muscle and gaining weight around the midsection, low mood, poor concentration and poor sleep. Every one of these has other possible causes, including sleep apnea, thyroid problems, medicines and stress, which is why we test rather than guess.
What does treatment involve if my levels are low?
Dr. Ewals sets a dose and shows you how the medicine is taken. Your medication and home-use supplies are shipped to you as part of the TRT membership. Follow-up visits are every 8 to 24 weeks, depending on the person, and your dose is adjusted from your lab results.
How often will I need labs on treatment?
Once your levels are stable, usually after 2 to 4 months, labs are typically every 3 to 6 months. They check testosterone, red blood cell count and other markers. Labs are billed by the lab and aren't included in the TRT membership.
What did the FDA change about testosterone in 2025?
Two things. After a large trial (TRAVERSE) found no increase in major heart problems, the FDA had testosterone labels updated to reflect those results. It also required a warning that testosterone can raise blood pressure, so Dr. Ewals monitors yours.
Who shouldn't take testosterone?
Men with or being evaluated for prostate or breast cancer, untreated severe sleep apnea, uncontrolled heart failure or a very high red blood cell count, and men trying to conceive now. Dr. Ewals goes through all of this before anything is prescribed.
Can testosterone treatment affect fertility?
Yes. Testosterone therapy can lower sperm production. If you might want children, say so at your first visit so you can discuss other options.
I'm already on testosterone elsewhere. Can I switch to you?
Yes. Email or fax your most recent labs and your last visit note (info@alternativehealthgf.com or (701) 757-0974), then call Will to book. Dr. Ewals reviews your records first. Depending on what they show, she may order additional testing before continuing your treatment.
No match on this page. Try all FAQs or call us.
Guides
Read Before You Visit
Patient guides with sources you can check. All guides
Men's health & testosterone · 5 min
Low Testosterone Symptoms: What an Evaluation Can and Cannot Tell You
Symptoms like low energy and low libido have many causes. Here is what a testosterone evaluation involves, what it can show, and what it cannot.
Men's health & testosterone · 4 min
What Monitoring May Be Discussed During Testosterone Treatment?
Testosterone treatment comes with regular follow-up. Here are the labs, check-ins, and symptoms your clinician may discuss, and why they matter.
Men's health & testosterone · 6 min
Sleep Apnea, Weight and Testosterone: Why They Are Checked Together
Tiredness, low libido and weight gain can point to sleep apnea as much as low testosterone. Here is why a careful workup looks at all three.
Ready when you are
Get Answers, Not a Sales Pitch
Request a consultation. If treatment isn't right for you, we'll tell you why and what else might help.