How Testosterone, GH, IGF-1, and Estrogen Work Together in Men

A Plain-English Map of the “Anabolic Team” Behind Muscle, Mood, and Recovery

Testosterone, GH, IGF-1, and estrogen in men form a coordinated anabolic team that supports muscle mass, bone density, fat distribution, mood, and recovery.

Many men across North Carolina start looking into their health after months of low energy, stubborn weight gain, loss of muscle, or a mood that feels flat for no clear reason. A primary care visit often leads to an antidepressant prescription, which is a reasonable first step and often the right one. At the same time, there are cases where hormones are playing a bigger role than anyone has checked for, and where a closer look at the full hormonal picture can change the direction of care.

Where this shows up clinically is in the workup, and I walk through that on my TRT telehealth page.

This article is a high-level overview of how four key anabolic hormones work together in the male body: testosterone, growth hormone (GH), insulin-like growth factor 1 (IGF-1), and estrogen (specifically estradiol, or E2). The goal is not to turn you into an endocrinologist, but to give you a clear mental model you can use as you read more detailed posts or consider a hormone evaluation.

If you live in North Carolina and are exploring testosterone replacement therapy (TRT), telehealth makes it possible to evaluate these issues discreetly and safely without traveling to a clinic.

On This Page

• Testosterone: The Central Anabolic Signal
• Growth Hormone and IGF-1: The Anabolic Amplifiers
• How Sleep, Exercise, and Body Fat Shape the GH/IGF-1 System
• Estrogen in Men: The Overlooked Anabolic Partner
• The Anabolic “Team”: How They Work Together
• What Happens to These Hormones as Men Age
• When Low Testosterone Looks Like Depression
• Common Questions Men Ask About These Hormones
• Red Flags and the Limits of “More Anabolism”
• Practical Steps You Can Take Now
• FAQs

Testosterone, GH, IGF-1, and Estrogen in Men: The Anabolic Team

Testosterone is the primary anabolic (growth-supporting) steroid hormone in the male body. It is produced mainly in the testes, under the direction of the hypothalamic-pituitary-gonadal axis (HPG axis), a signaling chain that starts in the brain and controls endogenous testosterone production through luteinizing hormone (LH) and other hormones.

Once released into the bloodstream, testosterone circulates in two main forms. Most of it is bound to sex hormone-binding globulin (SHBG) or to albumin, which makes it less immediately available to tissues. The remaining fraction is free testosterone, the portion that can bind to androgen receptors in muscle, bone, the brain, and other tissues and trigger anabolic signaling.

When serum testosterone levels are in a healthy range for your body, the effects show up across multiple systems. It helps to think about testosterone’s role in two broad buckets: direct and indirect.

Direct Effects (on Muscle and Bone):

• Supports skeletal muscle protein synthesis, especially when paired with regular resistance training
• Helps maintain or increase muscle fiber size and muscle strength over time
• Contributes to bone mineral density, which reduces fracture risk as men age
• Binds to androgen receptors in muscle and androgen receptors in bone, activating pathways that promote tissue growth and repair

Indirect Effects (on the Environment Your Body Builds In):

• Influences fat distribution and metabolism, which can make it easier to lose central or visceral fat when combined with diet and exercise
• Improves energy levels, motivation, and drive for many men, which makes it more realistic to stick with training, nutrition, and sleep routines
• Interacts with other hormones and growth factors (including IGF-1 and estradiol), which together help support recovery after exercise and adaptation to training
• Supports sexual function, mood regulation, and overall sense of well-being

When testosterone is low, the opposite pattern often develops over months to years: gradual loss of lean body mass, increased belly fat (particularly visceral fat), slower recovery, low mood, and a general sense that things require more effort than they used to. For some men, this looks very similar to clinical depression, which is one reason hormone-informed mental health care can be helpful.

In my practice, the focus is on restoring hormones to physiologic ranges, not chasing bodybuilding-style numbers, while paying close attention to mood, sleep, relationships, and long-term health.

Restoring testosterone to a physiologic (normal) range with TRT can help reverse many of these effects, especially when paired with strength training, adequate protein intake, and reasonable sleep quality. TRT is not a magic shortcut, but it can restore the foundation that makes your other efforts work better.

For more information on what TRT involves and what to expect:

• guide to testosterone therapy for North Carolina men
• How Adult Men Are Evaluated for Low Testosterone Before Treatment

Growth Hormone and IGF-1: The Anabolic Amplifiers

While testosterone is the central anabolic signal, it does not work alone. Growth hormone (GH), also called human growth hormone (HGH), is released by the pituitary gland in pulses throughout the day. The largest and most important pulses happen during deep sleep (specifically slow-wave sleep) and after intense exercise like heavy lifting or high-intensity interval training.

One of GH’s primary jobs is to signal the liver and other tissues to produce insulin-like growth factor 1 (IGF-1). This is sometimes referred to as hepatic IGF-1 production when discussing the liver’s role specifically. IGF-1 is the growth factor that carries out many of GH’s downstream anabolic effects, and the two are often discussed together as the GH/IGF-1 axis.

How GH and IGF-1 Support the Body:

• Tissue repair: IGF-1 promotes cellular growth and helps repair muscle fibers damaged during exercise. This is one of the main mechanisms behind exercise recovery and strength adaptation.
• Bone health: Both GH and IGF-1 contribute to bone density and bone mineral density maintenance. IGF-1 stimulates osteoblast activity (the cells that build new bone).
• Body composition: GH promotes fat breakdown (lipolysis), particularly from visceral fat stores, while IGF-1 supports muscle maintenance. Together, they influence the ratio of lean body mass to fat.
• Connective tissue: IGF-1 supports joint health and connective tissue integrity, which affects how you feel during and after exercise.

The Role of IGF Binding Proteins:

IGF-1 does not circulate freely in the blood. Most of it travels bound to a group of carrier proteins called IGF binding proteins (IGFBPs). The most abundant is insulin-like growth factor binding protein-3 (IGFBP-3), which carries roughly 75-80% of circulating IGF-1 in a stable complex.

These binding proteins serve several functions. They extend the half-life of IGF-1 in the bloodstream, regulate how much free IGF-1 is available to tissues at any given time, and help direct IGF-1 to specific target sites. The balance between bound and free IGF-1 (IGF-1 bioavailability) is one of the factors that determines how strongly the GH/IGF-1 system is actually working at the tissue level.

Research suggests that testosterone and estradiol both influence this balance. Evidence indicates that testosterone and estradiol regulate free IGF-1 availability in part by modifying levels of IGFBP-3 and other binding proteins. This is one of the ways the anabolic hormones interact with each other rather than working in separate lanes.

How Sleep, Exercise, and Body Fat Shape the GH/IGF-1 System

The GH/IGF-1 axis is not a fixed system. It responds to how you live. Several modifiable factors can either support or blunt its activity, and understanding these helps explain why lifestyle is not an afterthought in hormone-informed care.

Sleep and Growth Hormone Release:

Sleep quality is one of the most powerful regulators of growth hormone secretion. The largest GH pulses occur during the first one to two cycles of slow-wave sleep (deep sleep), typically within the first 90 minutes after falling asleep. This is a form of pulsatile secretion: GH is not released in a steady stream but in bursts timed to your circadian rhythm and sleep architecture.

When sleep is fragmented, shortened, or of poor quality, these pulses shrink. Chronic sleep deprivation has been shown to reduce GH output significantly, which in turn lowers IGF-1 levels. For men who are also dealing with low testosterone, poor sleep creates a compounding effect: both the testosterone signal and the GH/IGF-1 signal weaken at the same time.

Because this hormonal repair depends so heavily on quality sleep, some men ask whether restoring melatonin signaling helps. I cover the sleep and circadian evidence for the epitalon peptide separately.

Resistance Exercise and GH:

Resistance exercise (particularly heavy compound movements and higher-volume training) is one of the strongest acute stimulators of growth hormone release. The intensity and metabolic stress of the exercise session matter: exercises that challenge large muscle groups and produce significant fatigue tend to trigger larger GH pulses.

This exercise-induced GH response is one reason resistance training supports body composition changes beyond just burning calories. The GH released during and after a training session contributes to tissue repair, fat mobilization, and the overall recovery process.

Body Fat and the GH/IGF-1 Response:

Visceral fat (the fat stored around the organs in the abdominal cavity) has a suppressive effect on GH secretion. Men with higher levels of central obesity tend to have lower GH pulses and lower circulating IGF-1. This creates a cycle: low GH makes it harder to lose visceral fat, and excess visceral fat further suppresses GH.

Visceral fat also increases aromatase activity (the enzyme that converts testosterone to estradiol), which can shift the testosterone to estradiol balance in ways that affect mood, energy, and body composition. This interconnection between fat, hormones, and the GH system is one reason that body composition management is a core part of any hormone-informed treatment plan.

Stress and Cortisol:

Chronic stress and elevated cortisol (the body’s primary stress hormone) can suppress both testosterone production and GH secretion. Cortisol is catabolic: it promotes tissue breakdown rather than tissue building. When cortisol stays elevated over weeks or months, it directly opposes the anabolic effects of testosterone, GH, and IGF-1.

This is why stress management is not a vague wellness suggestion in this context. It is a physiologically relevant intervention that affects the same hormonal systems you are trying to support.

For more information on the connection between physical health and mental wellness:

• Metabolic Psychiatry: How Metabolic Health Shapes Mood
• A Psychiatrist’s Guide to Sleep Medications and Sleep Peptides

Estrogen in Men: The Overlooked Anabolic Partner

This is one of the most misunderstood areas in men’s hormone health. Many men are surprised to learn that estrogen is a normal and necessary hormone in their body, not a “female hormone” that should be eliminated.

Most estrogen in men comes from testosterone being converted by an enzyme called aromatase. This process, called aromatization, happens in body fat, the liver, muscles, the brain, and other tissues. The primary estrogen in men is estradiol (E2), and its levels are directly influenced by how much testosterone is circulating and how much aromatase activity is present.

How Estrogen Supports Anabolism in Men:

Just like testosterone, estradiol has both direct and indirect effects on the body’s ability to build and maintain tissue.

Direct effects (on bone and tissue health):

• Helps maintain bone mineral density through estrogen receptors in bone. Evidence suggests that estradiol may be even more important than testosterone for bone health in aging men.
• Supports joint health and connective tissue integrity, which affects how you feel during and after exercise
• Contributes to healthy sexual function and overall sense of well-being in many men

Indirect effects (on the hormonal environment):

• Is produced from testosterone, so estradiol levels reflect and help fine-tune overall hormone balance
• Interacts with the GH/IGF-1 system and can influence how your body responds to training and recovery
• Helps maintain a more stable internal environment for mood, sleep, and energy, which indirectly supports your ability to train, eat well, and stay consistent

Why “Zero Estrogen” Is the Wrong Goal:

The key is balance. When estradiol is too high relative to testosterone, men may notice symptoms like breast tenderness, swelling, fluid retention, or mood lability. When estradiol is pushed too low with aggressive estrogen-blocking medications (such as aromatase inhibitors), men can develop joint pain, low libido, low mood, and potentially reduced bone density over time.

Routine use of estrogen blockers “just in case” on TRT can do more harm than good. These medications may be considered when a man has clear symptoms and lab evidence of problematic estradiol levels, but they are not a default part of responsible TRT. The goal is always a healthy estrogen balance that supports the full range of health markers.

The goal is balance, not zero estrogen. Estradiol is not an enemy. It is a necessary partner in the anabolic system.

For additional information on gynecomastia and estrogen management:

• Gynecomastia on TRT: Causes, Symptoms, and Options

The Anabolic “Team”: How They Work Together

These hormones do not work in isolation. They form an interconnected anabolic system that functions best when all the pieces are in a reasonable range and working in coordination. Think of it less as four separate hormones and more as a single team with four key players.

A Practical Example:

After a good night of sleep (7-9 hours, with adequate time in slow-wave sleep) and a heavy resistance training session, the following sequence can unfold:

1. Testosterone helps signal muscle protein synthesis and strength adaptation at the androgen receptor level
2. Growth hormone pulses during the post-exercise window, which triggers an increase in IGF-1 production (primarily from the liver)
3. IGF-1 binds to the IGF-1 receptor on muscle cells and other tissues, supporting repair, recovery, and adaptation
4. Estradiol (made from testosterone through aromatase) helps maintain bone health and joint health, modulates the training response, and supports the stable mood and energy that allow you to keep training consistently

These processes overlap. Testosterone and growth hormone influence each other’s downstream effects. Growth hormone and IGF-1 work through shared and separate pathways. Estradiol’s role of insulin-like growth factors in the body is increasingly recognized: research suggests that testosterone and estradiol regulate free IGF-1 bioavailability through their effects on binding proteins.

Over time, this coordinated system is part of why consistent training, nutrition, and sleep can change your body composition and strength. The hormones provide the signaling environment; your daily habits provide the stimulus and raw materials.

The Neuroendocrine Connection:

The regulation of growth hormone and testosterone is controlled by the brain through what is broadly called neuroendocrine regulation. The hypothalamus releases signaling hormones that tell the pituitary gland when and how much GH to release, and the HPG axis regulates testosterone through LH and gonadotropin-releasing hormone (GnRH).

This means that factors affecting brain function (chronic stress, poor sleep, mood disorders, certain medications) can suppress the entire anabolic system from the top down. It is one reason why a psychiatric evaluation that includes hormonal factors can uncover issues that a standard depression screen might miss.

What Happens to These Hormones as Men Age

As men get older, several of these signals tend to decline. This is a gradual process, not a sudden switch, and the rate of decline varies significantly from one man to the next.

The General Pattern:

• Testosterone levels drift down by roughly 1-2% per year after age 30 in many men. This is not a disease by itself, but when levels drop low enough to produce symptoms (fatigue, loss of muscle, mood changes, reduced libido), it may meet the criteria for hypogonadism (clinically low testosterone).
• GH pulses become smaller and less frequent with age. GH secretion can decline by 50% or more between ages 30 and 60 in some individuals. This is sometimes called “somatopause.”
• IGF-1 levels fall in parallel with GH. Serum IGF-1 typically decreases by roughly 14% per decade in healthy older men, though body composition, nutrition, and exercise habits influence the rate.
• SHBG levels tend to rise with age, which means more testosterone is bound up and less is available as free testosterone, even if total testosterone looks acceptable on a lab report.

The result is a less responsive anabolic system overall: muscle is easier to lose, fat (especially visceral fat) is easier to gain, recovery after exercise is slower, bone density begins to decline, and mood can flatten.

What This Means Clinically:

The age-related decline in these hormones is not automatic justification for treatment. Many men age well without ever needing TRT or any other hormonal intervention. At the same time, assuming that fatigue, flat mood, and muscle loss are “just part of getting older” can delay evaluation of treatable conditions.

A dual evaluation that looks at both hormonal and psychiatric factors, checking serum testosterone levels (ideally two morning testosterone tests), IGF-1, estradiol, thyroid function, SHBG, and a thorough mental health assessment, helps clarify what is driving a man’s symptoms and what the most effective treatment plan would be.

When Low Testosterone Looks Like Depression

Low testosterone and depression share overlapping symptoms. Both can produce fatigue, low mood, reduced motivation, difficulty concentrating, irritability, sleep problems, and loss of interest in activities that used to feel rewarding. In some men, both conditions are present at the same time: both can, and often do, coexist.

This overlap is one of the most important reasons to consider a hormone-informed psychiatric evaluation rather than assuming every mood-related symptom is purely psychological or purely hormonal.

How the Overlap Creates Diagnostic Confusion:

A man with truly low testosterone who sees a primary care physician for fatigue and low mood may receive an antidepressant without anyone checking hormone levels. The antidepressant may help with some symptoms (especially if there is a genuine depressive component), but it cannot restore the hormonal foundation that is contributing to the problem. At the same time, a man who goes straight to a TRT clinic may get testosterone replacement without anyone evaluating his mental health. TRT can improve energy and mood in men with confirmed low testosterone, but it does not treat clinical depression, anxiety, trauma-related symptoms, or relationship problems.

The most effective approach is often to evaluate both: check the labs and do the psychiatric assessment in the same process. This is what hormone-informed psychiatry means in practice: not choosing between hormones and mental health, but looking at both.

I am not interested in replacing one form of treatment with another. I am interested in looking at the whole picture: hormones, mood, sleep, relationships, and the lifestyle factors that tie them together.

For more on how hormones and mood interact:

• Balancing Hormones and Mental Health: A Psychiatrist’s Guide for Men
• Testosterone and Anger: Low T vs. High T
• Low Testosterone and Depression: What the Overlap Means

Common Questions Men Ask About These Hormones

Men often bring practical questions that sit on top of this physiology. Here are the ones that come up most frequently.

Will TRT Alone Help Me Gain Muscle?

TRT can help restore the hormonal foundation that supports muscle gain, especially if your testosterone was truly low. Testosterone is the primary signal for muscle protein synthesis, and when it is deficient, the body’s response to resistance training is blunted.

At the same time, TRT is not a substitute for training, nutrition, and recovery. Most of the actual hypertrophy (muscle growth) is driven by progressive resistance exercise, adequate protein intake (many men do better when they increase protein within their overall calorie needs), and consistent recovery. TRT restores the environment where those efforts produce results.

Do I Need GH or Peptides, or Is TRT Enough?

For most men, optimizing lifestyle plus TRT (when indicated) is enough to meaningfully improve how the GH/IGF-1 system functions. Improving sleep quality directly increases GH pulses. Regular resistance training triggers exercise-induced GH release. Reducing visceral fat removes a major suppressor of GH secretion.

Peptide therapies or growth hormone replacement therapy carry additional risks, uncertainties, and regulatory considerations. They may be considered in specific clinical situations (such as documented adult growth hormone deficiency with confirmed testing), but they are not a routine add-on to TRT for most men.

Should I Take an Estrogen Blocker with Testosterone?

Routine use of aromatase inhibitors “just in case” is not recommended. They can suppress estradiol below the levels needed for bone health, joint health, mood stability, and sexual function. They may be considered when a man has clear symptoms and lab evidence of problematic estradiol levels, but the default approach on TRT is to monitor estradiol and address it only when needed.

The goal is a healthy testosterone to estradiol balance, not zero estrogen.

How Do I Know If My GH or IGF-1 Is Low?

An IGF-1 lab test can give you a snapshot of your GH/IGF-1 axis function. IGF-1 has a longer half-life than GH, so it is more useful as a screening marker. Results are typically interpreted using an age-adjusted reference range, since normal IGF-1 levels decline with age.

However, isolated IGF-1 testing without clinical context can be misleading. In most cases, the priority is to check testosterone, estradiol, thyroid function (TSH, free T4), prolactin, metabolic markers (fasting glucose, A1C), and a complete blood count (including hematocrit) before pursuing GH-specific testing. IGF-1 testing becomes more relevant when there is clinical suspicion of growth hormone deficiency based on symptoms and other findings.

Red Flags and the Limits of “More Anabolism”

More hormone is not always better. This is worth stating plainly because the online hormone optimization space often implies the opposite. Very high (supraphysiologic) testosterone or IGF-1 levels are associated with increased risks, including:

• Cardiovascular strain: elevated blood pressure, unfavorable lipid changes (lower HDL cholesterol, higher LDL cholesterol), and increased cardiovascular risk
• Blood thickening: high hematocrit (erythrocytosis), which increases blood viscosity and can raise the risk of clotting events
• Sleep apnea: TRT can worsen or unmask obstructive sleep apnea (OSA), which in turn suppresses GH secretion and disrupts the entire anabolic system
• Fertility problems: exogenous testosterone suppresses the HPG axis, which can reduce or halt spermatogenesis (sperm production) and cause testicular atrophy
• Mood instability: supraphysiologic levels can cause irritability, anxiety, or mood swings rather than the mood stability most men are looking for
• Prostate considerations: while evidence does not clearly link physiologic TRT to prostate cancer in men with normal baseline PSA, monitoring with prostate-specific antigen testing is standard practice

Combining multiple anabolic agents (high-dose testosterone, peptides, and other substances) without medical supervision amplifies these risks significantly.

A Safer Approach:

• Aim for the lowest effective dose that restores you to a healthy physiologic range
• Monitor labs regularly: testosterone, estradiol, hematocrit, lipids, PSA, liver function, fasting glucose, and other markers as appropriate
• Prioritize long-term health and function over short-term physique goals
• Report any concerning symptoms (chest pain, severe headaches, shortness of breath, visual changes, testicular pain, new urinary symptoms) right away

For more detail on TRT risks, monitoring, and safety:

• TRT Side Effects and Risks: What to Watch For and How Responsible Monitoring Works
• High Hematocrit on TRT: Why It Matters for Your Brain and Heart
• TRT and Heart Health: Blood Pressure, Cholesterol, and Mood

Practical Steps You Can Take Now

There are several things you can start doing at home that support this entire anabolic network, whether or not you ever pursue TRT. These are not vague wellness suggestions: each one directly influences the hormonal systems discussed in this article.

Sleep (7-9 Hours, Consistent Schedule):

Deep sleep is when the largest GH pulses occur. Fragmented or short sleep suppresses GH, lowers testosterone, and raises cortisol. Prioritize 7-9 hours of consistent, high-quality sleep. Dim lights and turn screens off 60-90 minutes before bed. Keep your sleep schedule as consistent as possible, even on weekends.

Resistance Training (2-4 Times Per Week):

Regular resistance training is one of the strongest stimulators of both testosterone and GH activity. It also directly drives the muscle protein synthesis that these hormones support. Scale the intensity to your current fitness level and any medical limitations. Compound movements (squats, deadlifts, presses, rows) tend to produce the strongest hormonal responses. Progressive overload (gradually increasing the challenge over time) is the key principle.

Protein Intake:

Aim for a protein intake that supports muscle maintenance and growth. Many men do better when they increase protein within their overall calorie needs. A common starting point is roughly 0.7-1.0 grams of protein per pound of body weight per day, though individual needs vary based on age, activity level, and goals.

Stress Management:

Chronic stress elevates cortisol, which directly opposes the anabolic signals you are trying to support. This can mean therapy, mindfulness, scheduling changes, simple breathwork (such as box breathing), or other coping strategies. The specific approach matters less than doing something consistently.

Body Composition:

Reducing visceral fat removes a major suppressor of GH secretion and a major source of excess aromatase activity (which can shift estrogen levels). Even modest reductions in waist circumference can improve hormonal profiles. The combination of resistance training, adequate protein, and reasonable calorie management is the most effective and sustainable approach.

Consistency beats intensity. Start with one or two of these and be consistent before trying to change everything at once.

For more on lifestyle strategies and their mental health benefits:

• Online Psychiatrist for Anxiety in North Carolina
• How Sleep Apnea and CPAP Affect Mood: A Psychiatrist’s Patient Guide

FAQs

What is the difference between GH and IGF-1?

Growth hormone (GH) is released by the pituitary gland in pulses and acts as a signaling hormone. Its main downstream effect is to stimulate the liver and other tissues to produce insulin-like growth factor 1 (IGF-1). IGF-1 is the growth factor that carries out many of GH’s anabolic effects at the tissue level, including muscle repair, bone maintenance, and cellular growth.

Can TRT improve my GH and IGF-1 levels?

Restoring testosterone to a physiologic range can have indirect benefits on the GH/IGF-1 system. TRT often improves sleep quality, energy, and the ability to exercise, all of which support better GH secretion. Evidence also suggests that testosterone and estradiol influence IGF-1 bioavailability through their effects on binding proteins. However, TRT is not a direct treatment for growth hormone deficiency.

Why does my doctor check estradiol when I am on TRT?

Estradiol is produced from testosterone through aromatase conversion. When testosterone levels increase on TRT, estradiol often rises as well. Monitoring estradiol helps ensure the testosterone to estradiol balance stays in a healthy range. Too high or too low can both cause symptoms, and the goal is balance rather than suppression.

Is it normal for men to have estrogen?

Yes. Estrogen (specifically estradiol) is a normal and necessary hormone in men. It supports bone density, joint health, sexual function, and mood. Most estradiol in men comes from testosterone through the enzyme aromatase. Problems arise only when levels are significantly too high or too low relative to testosterone.

How do I know if my symptoms are from low testosterone or depression?

The symptoms overlap significantly: fatigue, low mood, reduced motivation, difficulty concentrating, and loss of interest. A dual evaluation that includes both lab work (serum testosterone, estradiol, thyroid function, and other markers) and a thorough psychiatric assessment is the most reliable way to distinguish and address both when they coexist.

What lifestyle changes have the biggest impact on these hormones?

Sleep quality and resistance training have the strongest evidence for supporting both testosterone and GH/IGF-1 activity. Reducing visceral fat, managing chronic stress, and ensuring adequate protein intake are also directly relevant. These are not substitutes for medical treatment when hormones are clinically low, but they are essential partners in any treatment plan.

Should I be concerned about IGF-1 and cancer risk?

Elevated IGF-1 levels (particularly at supraphysiologic levels) have been associated with increased risk of certain cancers in some research. However, this primarily applies to levels well above the normal range. Physiologic replacement and lifestyle-driven improvements in IGF-1 within the normal reference range have not been clearly linked to increased cancer risk in the available evidence. Regular monitoring helps keep levels in a safe range.

If you are in North Carolina and are exploring whether a hormone-informed mental health plan, including possible TRT, makes sense for your situation, you can schedule a confidential telehealth consultation with Dr. Baghel.

Note: Nothing in this article is medical advice or a substitute for an in-person evaluation. If you have concerns about your testosterone, estrogen, growth hormone, or other hormonal issues, please speak with a licensed provider. For urgent or emergency symptoms, seek immediate medical care or call 911.