Heart & Vitality was created by a Cardiologist that understands the risk factors responsible for the #1 killer of Americans. Unlike many hormone replacement institutions, Heart & Vitality offers a wide range of services that provide convenience and superior service to our clients. We are staffed with highly trained medical professionals whose goals are to provide you with your nutritional needs, exercise regimen, and hormone replacement therapies in the most convenient and professional way possible. We know you want to be in and out of our office as quickly as possible, so seeing you right away is our priority. We are a friendly neighborhood medical office with a genuinely caring and professional staff. In addition, our medical professionals are available by phone or email to answer our client’s questions.

After your free consultation with our center manager, an appointment will be made for blood work to determine your base line hormones. After the lab results are received, you will be scheduled for the pellet insertion. 5 weeks post initial insertion, you will have a follow up lab. If additional pellets need to be inserted to better meet our goal, this will be done at this time. 1-2 weeks prior to the next insertion (approximately 90 days, ) blood work will be done again. Once the results are received, the second insert will be completed. This step will repeat itself every 90 days.

Testosterone is a hormone produced primarily in the testicles which helps maintain bone density, fat distribution, muscle strength, lean muscle mass, sex drive, and red blood cell production. Testosterone peaks during adolescence and early adulthood. Aging causes testosterone levels to gradually decline after age 30 (decline is approximately 1-2% per year).

Normal levels can vary from one laboratory to another laboratory, but it is measured as a concentration in the blood serum and has a significant range from 200ng/dL to 1200ng/dL. It is very important to correlate clinical symptoms with testosterone levels in each individual.

There are multiple causes of low testosterone in men. Common conditions associated with low testosterone include injury to the testicles, testicular treatment for cancer, certain medications, hormonal disorders from pituitary disorders, infection, chronic liver or kidney disease, type 2 diabetes, or obesity and aging.

Some of the common associated signs and symptoms of low testosterone levels include changes in sexual function, reduced muscle bulk and strength, physical changes such as increased body fat, and decreased bone density. Some emotional changes include decreased motivation, decreased self-confidence, sadness or depression, and loss of concentration. Do you have a decrease in strength and/or endurance? Are your erections less strong? Often erectile dysfunction is thought to be due to lack of blood flow but it could all be due to low testosterone.

Women do need testosterone, however in very small doses. Men’s hormonal needs are mainly centered around testosterone, while women need estrogen and other hormones to remain in balance.

With each program designed to treat the symptoms of low testosterone, Heart and Vitality uses superior grade medicine to treat Low T. Theses hormones are long-acting and are considered the safest and most effective compounds for use in Testosterone Replacement Therapy. TRT is secure and effective, as long as it is properly supervised by a trained physician. Testosterone Replacement Therapy is FDA approved.

Bio-Identical hormones contain the exact chemical makeup as the hormones that are naturally produced in the body. This also means that the body cannot differentiate this hormone from others that pre-exist, so the body will not re-metabolize those components. Studies have shown that these hormones also carry less risk of side effects than other types of hormones.

Pellets are a type of delivery system for hormones implanted under the skin (usually in the upper hip area). They are very small and the procedure is painless with no downtime involved. Hormones delivered this way can last up to three months, making this the most convenient and less time consuming option for Hormone Replacement Therapy.


Benefits of TRT (Testosterone Replacement Therapy) at Heart and Vitality vary based upon the pre-therapy Low T symptoms and other factors, but can include: increased bone mineral density, improved sexual desire, increased energy, decreased irritability and depression, improved cognitive function and verbal memory, higher motivation, decreased body fat, and better mood and improved erectile function.

Benefits of HRT (hormone replacement therapy) at Heart and Vitality vary based upon the pre-therapy hormonal imbalance symptoms and other factors, but can include: increased bone mineral density, improved sexual desire, pain free intercourse, reduction or disappearance of hot flashes and night sweats, decreased irritability and depression, improved cognitive function and verbal memory, higher motivation, decreased body fat, better mood, improved hair, skin, and nails.


For men, side effects will vary with the individual. Known side effects may include acne due to an increase in sebaceous gland activity, tender breast tissue, enlargement of the prostate, fluid retention, worsening of existing sleep apnea, increase in red blood cell count (which can be beneficial in patients with chronic anemia), decrease in sperm count, possible hair loss. For women, side effects may include headaches, nausea, and breast tenderness. Individuals are monitored for potential side effects through clinic visits, frequent communications, and laboratory testing.

Gels and Patches can be messy, inconvenient, and skin absorption may vary from individual to individual. There are significant dangers if women and children are exposed to testosterone from the gel. Male clients have to be very diligent in hand washing and bathing prior to engaging in contact with women and children. Patches may cause local skin reactions. Transdermal method of treatment increases the conversion of the T to DHT which can affect the hair follicles and prostate to a greater degree. There are two main advantages to Intramuscular Testosterone Injections versus other TRT replacement methods. If you really want to see the improvements in symptoms, no delivery mode is more effective than testosterone injections or pellets. Gels and patches often require dose adjustments to get the desired blood concentration and as many as 20% of patients never absorb enough testosterone from gels and patches to improve symptoms. Intramuscular Injections may cause temporary pain at the injections site, and pellet implants may cause some discomfort for a few days until the implant site heals.

Hormone replacement therapy is not recommended and/or is prohibited for patients with:

  • Breast or prostate cancer
  • A palpable prostate nodule
  • Severe lower urinary tract symptoms associated with benign prostatic enlargement
  • Unexplained PSA elevation
  • Unstable severe congestive heart failure (class III or IV)
  • Uncontrolled severe heart failure
  • Erythrocytosis (High red blood cell count)
  • Untreated obstructive sleep apnea

Multiple scientific studies have shown no correlation between testosterone replacement therapy and the development of malignancy in men. However, use of testosterone with either breast or prostate cancer is contraindicated as the testosterone therapy has been show to stimulate the progression of these cancers. For women, some hormone replacement therapies have been shown to reduce the risk of some types of ovarian cancer in certain patients. There is an increased risk of heart attacks or strokes for women that have heart disease. During the initial assessment, Dr. Abraham Jacob will be able to determine any risk factors based on your individual test results, and discuss them with you personally.