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MALE HORMONE OPTIMIZATION

Hormones,
measured properly.

Testosterone optimization isn’t a one-number conversation. It’s a question of free vs. total T, the supporting hormones around it, and what your symptoms are telling us — measured together, treated together, monitored together.

Testosterone free + total · LC-MS/MS

100+ biomarkers per patient

Physician-monitored dosing

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THE PROBLEM

Decline is gradual. So is the evidence.

Testosterone declines roughly 1% per year after 30 — faster with poor sleep, chronic stress, excess body fat, and metabolic dysfunction. The symptoms arrive slowly: less energy, slower recovery, softer body composition, a mind that doesn’t sharpen the way it used to. Most men feel the change years before anyone measures it.

Optimization at Peak starts with finding out what’s actually happening. Total testosterone is one number. What matters is the system around it — free T, estradiol, SHBG, the pituitary signals upstream, and the metabolism underneath. We test all of it before we treat any of it.

WHO THIS IS FOR

The symptoms are real. The labs said normal.

  • Energy, drive, or recovery that isn’t what it was
  • Strength and muscle that are harder to keep, despite consistent training
  • Brain fog, low motivation, or flat mood
  • Weight gain — especially around the midsection — that resists real effort
  • Symptoms that persist after being told your labs are “normal”

Not every man needs testosterone. Some need sleep, body composition, or metabolic work first — and the testing tells us which. If therapy isn’t indicated, we’ll say so.

THE PROCESS

Dosed to your physiology — not population averages.

STEP 01
ASSESSMENT
A comprehensive hormone panel by LC-MS/MS, alongside DEXA body composition, resting metabolic rate, and VO₂ max. Hormones don’t operate in isolation — we measure them in the metabolic context that drives them.
STEP 02
PROTOCOL
Dr. Lyall reviews the complete picture and builds the plan: testosterone replacement, medications that stimulate your own production, or the non-hormonal levers the data points to first.
STEP 03
MONITORING
Quarterly hormone follow-ups. Comprehensive re-testing twice a year. DEXA and VO₂ max tracked over time, with dosing adjusted as your data changes — not on a fixed schedule.

THE PANEL

One number can’t answer a systems question.

Most clinics test testosterone with immunoassays — fast, cheap, and imprecise at exactly the levels that matter. We use LC-MS/MS — liquid chromatography with mass spectrometry, the reference method for hormone measurement — for testosterone and estradiol.

  • Testosterone, free and total (LC-MS/MS)
  • Sensitive estradiol (LC-MS/MS)
  • SHBG — the binding protein that determines how much of your testosterone is usable
  • LH & FSH — the pituitary signals that show where the problem starts
  • DHEA-S & cortisol — adrenal function and the stress axis
  • Thyroid panel — the other signaling system symptoms get blamed on

Alongside the bloodwork: DEXA body composition, resting metabolic rate, and VO₂ max — because body fat, metabolism, and fitness move hormones as much as hormones move them.

IF THERAPY IS INDICATED

More than one way forward.

  • Testosterone injections — prescribed by Dr. Lyall, shipped to your home or fulfilled locally, with physician-monitored dosing.
  • Pellet therapy — a long-acting option for stable levels without an injection schedule.
  • Clomiphene — stimulates your body’s own production; an option for men who’d rather not start exogenous testosterone.
  • HCG — supports natural production and preserves fertility and testicular function, alone or alongside TRT.
  • Non-hormonal protocols — supplement, lifestyle, and metabolic optimization when the data says therapy isn’t the answer yet.

WHERE IT LIVES

Start targeted. Expand when the data says to.

THE STARTING POINT

Peak Foundations.

Hormone optimization is the core use case — a targeted lab panel, single-area optimization, and physician review of results.
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THE FULL PICTURE

Peak Longevity.

Hormones managed inside the full picture — cardiovascular, metabolic, strength, all six systems — with comprehensive re-testing and continuous oversight built in.
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WHAT’S NEXT

Normal for your age is a low bar. We measure against a better one.

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Testing and treatment are done from our Meridian office, serving men across Boise, Meridian, and Eagle.