Testosterone Replacement Therapy for Men Over 40: Benefits, Risks, Testing, and What to Expect

Low energy, can’t get it up, stubborn belly fat that won’t budge no matter what you do. You’ve probably seen the ads promising TRT will fix everything.

Here’s what they don’t tell you: testosterone replacement therapy is a medical treatment for diagnosed hypogonadism. It’s not a magic pill for getting shredded or feeling 25 again. If you actually have clinically low testosterone and the symptoms to match, TRT can significantly improve your quality of life. If you don’t, you’re just messing with your hormones for no reason and creating problems you didn’t have before.

This guide breaks down what TRT actually is, who it’s for, what it can and cannot do, the risks nobody wants to talk about, and how to know if you’re a candidate. I’m also covering the training and lifestyle factors that determine whether TRT helps you or just empties your wallet while screwing up your bloodwork.

No hype. No clinic marketing. Just what men over 40 actually need to know before making this decision.

If you suspect low testosterone, start with proper testing, not guesswork. Get training and nutrition guidance built for your actual hormone profile.

What Is Testosterone Replacement Therapy (TRT)?

Testosterone replacement therapy is medical treatment prescribed when a man has consistently low testosterone levels plus symptoms of hypogonadism. It’s designed to restore testosterone to normal physiological range, not to give you superhuman levels.

What TRT is used for: Treating diagnosed testosterone deficiency (hypogonadism) that’s causing legitimate medical symptoms. Low libido, erectile dysfunction, severe fatigue, loss of muscle mass, mood changes, the works.

What TRT is not for: Performance enhancement, getting jacked, anti-aging miracle cure, or fixing problems that have nothing to do with hormones. Half the guys who think they need TRT actually need better sleep, less stress, more weight training, and to stop drinking every night.

The diagnosis requires two things: blood tests showing low testosterone on at least two separate occasions (usually below 300 ng/dL), taken in the morning when levels peak, plus actual symptoms that match. Numbers alone don’t mean you need treatment. Symptoms alone don’t mean you need treatment. You need both.

Testosterone replacement therapy (TRT) is a medical treatment used when a man has consistently low testosterone levels and symptoms of hypogonadism. For men over 40, TRT can improve quality of life, but it requires proper testing and ongoing monitoring.

Symptoms of Low Testosterone After 40 (Common Signs)

Testosterone gradually declines about 1.6% per year starting in your mid-30s. For most men, this is normal aging and doesn’t require treatment. For some, the decline is steep enough to cause real problems.

Sexual symptoms:

  • Decreased libido (legitimately low sex drive, not just “not as horny as when I was 20”)
  • Erectile dysfunction that’s persistent and progressive
  • Reduced spontaneous erections (morning wood disappearing completely)

Energy and mood:

  • Crushing fatigue that doesn’t improve with sleep
  • Depression or persistent low mood
  • Irritability, brain fog, difficulty concentrating
  • Loss of motivation and drive

Body composition and strength:

  • Noticeable loss of muscle mass despite training
  • Increased body fat, especially around the midsection
  • Strength decline that’s not explained by training changes
  • Difficulty building or maintaining muscle even with proper program and nutrition

Recovery and sleep:

  • Poor recovery from workouts
  • Sleep disturbances, reduced sleep quality
  • Feeling perpetually run down

Nearly 40% of men over 45 meet biochemical criteria for low testosterone. But biochemistry alone doesn’t warrant treatment. The symptoms matter more than the number on a lab test.

How Do You Know If You Have Low Testosterone?

Stop diagnosing yourself based on internet symptom checklists. Get actual blood work.

Testing basics (what doctors look for)

Morning blood draws are non-negotiable. Testosterone levels follow a circadian rhythm and peak between 7-11 AM. Test in the afternoon and you’ll get artificially low results that don’t reflect your actual status.

At least two separate tests. One low result doesn’t mean anything. Stress, illness, poor sleep, hard training can all temporarily tank your levels. Proper diagnosis requires repeat testing showing consistently low values.

Total testosterone vs free testosterone: Total testosterone measures bound and unbound hormone. Free testosterone is what’s biologically active. Both matter. The threshold is typically below 300 ng/dL for total testosterone, though this varies by lab and guideline. Ask for SHBG as well.

Why symptoms alone aren’t enough: Fatigue, low libido, and mood issues have dozens of possible causes. Sleep apnea. Hypothyroidism. Depression. Vitamin D deficiency. Chronic stress. Bad diet and no exercise. Treating these like they’re testosterone problems wastes time and money.

To know if you need TRT, most clinicians look for a combination of symptoms plus repeat morning blood tests showing low testosterone. This helps avoid treating the wrong problem, like sleep apnea, high stress, or medication side effects.

What tests are typically required before starting TRT?

Your doctor decides what you need, but standard workup usually includes:

  • Testosterone (total and free): Repeat testing to confirm low levels
  • Complete blood count (CBC): Baseline hematocrit and hemoglobin
  • PSA (prostate-specific antigen): For men over 40-50, depending on risk factors
  • Lipid panel: Cholesterol and triglycerides
  • Liver function tests: Baseline values
  • LH and FSH: Distinguish primary from secondary hypogonadism
  • Estradiol: Baseline estrogen levels
  • Thyroid function: Rule out thyroid issues mimicking low T symptoms

This isn’t optional. Proper screening prevents treating the wrong condition and establishes baseline values for monitoring once treatment starts.

When Is TRT Medically Appropriate?

TRT is appropriate when you have diagnosed hypogonadism: consistently low testosterone levels plus symptoms that significantly affect your quality of life.

Diagnosed hypogonadism means both:

  1. Lab-confirmed low testosterone on repeat testing
  2. Clinical symptoms consistent with testosterone deficiency

Important rule-outs before starting TRT:

  • Sleep apnea (common, often undiagnosed, tanks testosterone naturally)
  • Obesity (fat tissue converts testosterone to estrogen)
  • Medications that lower testosterone (opioids, corticosteroids)
  • Pituitary or testicular disorders requiring different treatment
  • Depression or other psychiatric conditions
  • Chronic medical conditions affecting hormone production

Fertility considerations are critical. Exogenous testosterone suppresses sperm production in most men. If you want to have kids, TRT is probably not appropriate. Alternatives like  hCG can boost testosterone while preserving fertility. Talk to a reproductive endocrinologist or urologist specializing in male fertility, not a TRT clinic that just wants to sell you testosterone.

Contraindications (when you shouldn’t use TRT):

  • Active, untreated prostate cancer (some exceptions with close monitoring)
  • Hematocrit above 50% at baseline
  • Untreated severe sleep apnea
  • Planning to conceive children soon
  • History of breast cancer
  • Uncontrolled heart failure

The Endocrine Society guidelines specifically recommend against routinely prescribing testosterone to all men over 65 with low testosterone levels. Age alone doesn’t justify treatment. You need symptoms plus low levels.

Benefits of TRT for Men Over 40 (What to Expect)

Let’s separate what TRT can actually do from the marketing promises.

Sexual function (most consistent benefit): Improved libido and erectile function are the most reliably documented benefits of TRT. The American College of Physicians guidelines recommend TRT specifically for sexual dysfunction in men with diagnosed low testosterone. If sexual symptoms improve, continue treatment. If they don’t improve after a reasonable trial (3-6 months), stop. That’s the evidence-based approach.

Energy and mood (variable): Some men experience significant improvements in energy, mood, and sense of well-being. Others see minimal changes. Research shows little to no improvement in depression, energy, or vitality for many men. This doesn’t mean it won’t help you, but don’t expect miracles.

Muscle mass and strength (with training): TRT can support muscle gain and strength improvements, especially when combined with resistance training. Studies in older men show improvements in lean body mass and muscle strength with testosterone treatment. But here’s the catch: you still have to train hard and eat right. TRT doesn’t build muscle sitting on the couch.

Fat loss (indirect support): TRT may help reduce body fat, particularly visceral (abdominal) fat. But it’s not a fat burner. The mechanism is indirect: better energy means you train harder, improved muscle mass increases metabolic rate slightly, better mood means you stick to your diet. The fat loss still comes from calorie deficit and consistent training.

TRT can support muscle gain and fat loss indirectly by improving energy, recovery, and training capacity. But the biggest body-composition changes still come from consistent strength training, nutrition, and sleep.

What TRT does NOT do:

  • Cure diabetes, though it may improve insulin sensitivity modestly
  • Reverse severe obesity without diet and exercise changes
  • Build muscle without training
  • Fix relationship problems, career stress, or general life dissatisfaction
  • Make you feel 25 again
  • Guarantee improved athletic performance

Set realistic expectations or you’ll be disappointed and blame the therapy when the problem is your unrealistic assumptions.

Risks and Side Effects of TRT (The Downsides)

Every medical treatment has risks. TRT is no exception. Anyone telling you it’s perfectly safe is either ignorant or lying to sell you something.

Common side effects (manageable but real):

  • Acne and oily skin: Testosterone stimulates sebaceous glands. Adult acne is common, especially on back and shoulders.
  • Fluid retention: Mild swelling, weight gain from water retention.
  • Mood changes: Some men experience irritability, mood swings, or increased aggression.
  • Testicular shrinkage: Your testicles stop producing testosterone when you’re on TRT, so they atrophy. This is expected and usually reversible if you stop treatment.
  • Breast tenderness or gynecomastia: Testosterone converts to estradiol (estrogen) via aromatase enzyme. If estrogen gets too high, breast tissue can develop. Manageable with aromatase inhibitors if needed.

Hematocrit elevation (serious, requires monitoring): This is the big one that many clinics downplay. TRT stimulates red blood cell production. Elevated hematocrit affects 5-66% of men on TRT, making it one of the most common side effects.

When your hematocrit goes too high (above 52-54%), your blood becomes thicker and more viscous. This increases risk of blood clots, heart attack, and stroke. Research shows that men who develop significantly elevated hematocrit on TRT have increased risk of major adverse cardiovascular events.

Hematocrit monitoring is non-negotiable. You need blood work at 3, 6, and 12 months after starting TRT, then periodically thereafter. If your hematocrit climbs above 52%, options include reducing your TRT dose, switching formulations, therapeutic phlebotomy (blood donation), or stopping treatment.

Fertility suppression (nearly universal): TRT shuts down your body’s natural testosterone production via negative feedback on the hypothalamic-pituitary-gonadal axis. This suppresses sperm production in most men. Some men become completely azoospermic (zero sperm count). This effect is usually reversible after stopping TRT, but recovery can take months to years. If you want kids, TRT is not the right choice.

Sleep apnea considerations: TRT can worsen obstructive sleep apnea or unmask previously undiagnosed sleep apnea. If you have sleep apnea, it needs to be treated before starting TRT. If you develop symptoms (loud snoring, daytime fatigue, gasping for air during sleep), get evaluated immediately.

Cardiovascular considerations: For years, testosterone products carried an FDA black box warning about cardiovascular risk. In February 2025, the FDA removed this warning after reviewing the TRAVERSE trial, which showed testosterone therapy did not increase cardiovascular risk in a large clinical trial.

That said, TRT can raise blood pressure. It can elevate hematocrit (as discussed). Both of these can contribute to cardiovascular issues if not monitored and managed. The current evidence suggests TRT is reasonably safe from a cardiovascular standpoint when properly monitored, but it’s not risk-free.

Hair loss (if you’re genetically predisposed): Testosterone converts to DHT (dihydrotestosterone), which accelerates male pattern baldness in men with genetic susceptibility. If you’re already balding, TRT may speed it up. If you’re not genetically predisposed, you’re probably fine.

When to seek immediate medical help:

  • Severe shortness of breath
  • Chest pain or pressure
  • Sudden severe headache
  • Vision changes
  • Leg pain, swelling, or redness (signs of blood clot)
  • Priapism (erection lasting over 4 hours)

Injections vs Gels vs Other Forms (What’s the Difference?)

TRT delivery methods all get testosterone into your system. They differ in convenience, cost, blood level stability, and side effect profiles.

Injections (intramuscular)

Pros:

  • Most cost-effective ($156 annually vs $2,135 for transdermal in 2016 Medicare data)
  • Convenient dosing (weekly, biweekly, or longer depending on formulation)
  • Effective and well-studied
  • Can self-administer at home after training

Cons:

  • Peaks and troughs in blood levels (can cause mood/energy fluctuations)
  • Injection anxiety for some men
  • Requires proper technique to avoid complications
  • Higher risk of hematocrit elevation compared to daily gels

Common formulations: Testosterone cypionate, testosterone enanthate (inject weekly or every 2 weeks), testosterone undecanoate (inject every 10-12 weeks, less common in US).

Gels and creams (transdermal)

Pros:

  • Daily application provides more stable blood levels
  • No needles
  • Easy to adjust dose
  • Lower risk of significant hematocrit spikes

Cons:

  • Expensive (over 10x the cost of injections)
  • Daily application required (compliance issue for some)
  • Transfer risk to women and children through skin contact
  • Skin irritation possible
  • Variable absorption between individuals
  • Very low absorption rate

Application sites: Upper arms, shoulders, abdomen depending on formulation. Wash hands thoroughly after application. Cover area or wear shirt to prevent transfer to others.

Patches (less common)

Apply daily, usually at night. Similar pros/cons to gels but with higher rates of skin irritation. Not as popular as gels or injections.

Pellets (subcutaneous implants)

Small pellets implanted under the skin every 3-6 months. Provides steady release. Convenient (don’t think about daily dosing) but invasive (requires minor surgical procedure for insertion), expensive, and difficult to adjust dose if levels aren’t optimal or side effects develop.

Delivery MethodFrequencyBlood Level StabilityProsConsBest For
Injections (IM)Weekly to biweeklyModerate (peaks/troughs)Low cost, effective, convenientNeedles, fluctuating levelsMost men, especially cost-conscious
Gels/CreamsDailyHigh (steady levels)No needles, stable levelsExpensive, transfer risk, daily complianceMen who can’t tolerate injections
PatchesDailyHighStable levelsSkin irritation, costRarely first choice
PelletsEvery 3-6 monthsVery highSet and forgetSurgical procedure, expensive, hard to adjustMen wanting minimal maintenance

The American College of Physicians recommends considering intramuscular injections over transdermal formulations due to significantly lower cost and similar effectiveness. Most men can learn to self-inject at home without issues.

How Long Does It Take to See Results From TRT?

Stop expecting overnight transformations. Testosterone isn’t magic.

Early changes (2-4 weeks): Some men notice improvements in libido and sexual function within the first few weeks. Energy and mood may improve. Others feel nothing yet. This is highly variable.

Mid-term changes (1-3 months): Training performance and recovery often improve. You might notice better workouts, less fatigue between sessions, improved strength progression. Sexual function continues improving for men who respond. Body composition starts shifting subtly if you’re training and eating right.

Longer-term changes (3-6+ months): Muscle mass and body fat changes become noticeable. These depend heavily on training and nutrition, not just TRT. Bone density improvements (measured, not felt). Sustained improvements in libido, energy, and mood for responders.

Many men notice TRT effects in phases. Some feel changes in energy and libido within weeks, while muscle and body composition changes typically take months and depend heavily on training and nutrition.

“Do you have to stay on TRT for life?”

Not necessarily, but for many men, yes. If you stop TRT, your testosterone levels return to whatever they were before treatment (still low). Your symptoms return. Some men use TRT for a defined period, then try to restart natural production with medications like hCG or clomiphene. This sometimes works, sometimes doesn’t.

The decision to start TRT should factor in that you’re probably committing to long-term or lifelong treatment. Stopping requires a plan and medical supervision to manage the transition.

TRT + Training: How to Improve Muscle, Fat Loss, and Recovery

TRT creates a more favorable hormonal environment for building muscle and losing fat. But it doesn’t do the work for you. Training and nutrition are still the primary drivers.

Strength training plan (simple, joint-friendly)

Frequency: 3-4 days per week. Full-body or upper/lower split.

Progressive overload: Add weight, reps, or sets over time. Track your lifts. If you’re not getting stronger over weeks and months, something’s wrong with your program or recovery.

Cover the movement patterns: Squat, hip hinge, push and pull form the foundation. Add accessories as needed, but don’t skip the basics.

Volume: 10-20 hard sets per muscle group per week. Don’t overdo it just because you’re on TRT. More is not always better, especially after 40 when recovery capacity is limited.

Intensity: Most sets should be RPE 7-8 (2-3 reps from failure). Save the absolute grinders for your last set or two.

Joint-friendly exercise selection: Trap bar deadlifts over conventional, goblet or front squats over back squats if you have mobility issues, incline pressing over flat if shoulders are cranky. Train smart for longevity.

Cardio and conditioning

Daily steps: 7,000-10,000 steps for general health, fat loss support, cardiovascular health.

Zone 2 cardio: 2-3 sessions of 30-45 minutes weekly at a pace where you can still hold a conversation. Builds aerobic base, supports heart health, aids recovery without interfering with strength training.

Optional higher intensity work: 1-2 sessions of interval training if you’re conditioned for it and recover well. Not necessary for most men over 40 whose primary goal is muscle and strength.

Recovery rules

Sleep is non-negotiable: 7-9 hours nightly. TRT doesn’t compensate for chronic sleep deprivation. Poor sleep tanks recovery, blunts muscle growth, and increases injury risk.

Injury prevention: Warm up properly, use good technique, don’t chase PRs every workout, listen to your body. Being on TRT doesn’t make you invincible. Your tendons and ligaments still need time to adapt.

Manage stress: Chronic stress elevates cortisol, which interferes with testosterone’s benefits. Find what works: meditation, walks, therapy, hobbies. This isn’t optional.

Natural Alternatives to TRT (What to Try First)

Before jumping to TRT, fix the obvious problems most men ignore.

Sleep optimization: Get 7-9 hours of quality sleep consistently. Sleep deprivation significantly lowers testosterone. Fix your sleep and retest before assuming you need TRT.

Body fat reduction: Obesity lowers testosterone because fat tissue contains aromatase enzyme that converts testosterone to estrogen. Lose the excess fat (especially visceral fat) and testosterone often improves significantly.

Resistance training: Lifting heavy weights, particularly compound movements, stimulates testosterone production. If you’re sedentary with low testosterone, start training consistently for 3-6 months and retest before considering TRT.

Alcohol reduction: Excessive alcohol consumption suppresses testosterone production and increases estrogen. Cut back or eliminate alcohol and see what happens to your levels.

Stress management: Chronic stress and elevated cortisol suppress testosterone. Address your stress through whatever means work: therapy, meditation, lifestyle changes, better work-life balance.

Vitamin D (if deficient): Vitamin D deficiency is associated with lower testosterone. Get your levels tested. If low, supplement with 2000-4000 IU daily and retest in 2-3 months.

Myth-busting: “No ejaculation for 7 days boosts testosterone” This is based on one small study showing a temporary spike on day 7 of abstinence, followed by return to baseline. It’s not a treatment strategy. It’s a temporary fluctuation with no meaningful clinical impact. Don’t waste your time.

If you can fix sleep, lose fat, train consistently, manage stress, and address deficiencies, do that first. Many men see testosterone improve into normal range without ever needing TRT.

Monitoring and Follow-Up (Blood Tests and Check-Ins)

TRT requires ongoing medical supervision. This isn’t optional.

Blood test frequency (general guidelines):

  • 3 months after starting: Full panel including testosterone, hematocrit, PSA, lipids, liver function
  • 6 months: Repeat monitoring
  • 12 months: Comprehensive panel
  • Annually thereafter if stable: Minimum monitoring
  • More frequently if issues develop: Hematocrit elevation, symptoms, dose adjustments

What doctors monitor and why:

  • Testosterone levels: Ensure you’re in therapeutic range, not too low or excessively high
  • Hematocrit/hemoglobin: Watch for dangerous elevation
  • PSA (prostate-specific antigen): Monitor for prostate changes (age-dependent screening)
  • Lipid panel: Track cholesterol and triglycerides
  • Liver function: Especially important with oral formulations
  • Estradiol: Watch for excessive aromatization to estrogen
  • Blood pressure: Regular monitoring for hypertension

Why self-medicating is dangerously stupid: Ordering testosterone online without medical supervision is a recipe for disaster. You bypass proper diagnosis (maybe you don’t even have low testosterone). You skip baseline testing (no way to monitor for side effects). You have no medical oversight when problems develop. You risk legal issues (testosterone is a controlled substance). Don’t be an idiot.

Frequently Asked Questions

Is TRT safe for men over 40?

TRT is reasonably safe when properly prescribed and monitored by a physician. The FDA removed the cardiovascular black box warning in 2025 after large clinical trials showed no increased cardiovascular risk. However, TRT requires ongoing monitoring for hematocrit elevation, blood pressure, prostate health, and other potential side effects. It’s safe when done right. It’s risky when done poorly or without medical supervision.

Does TRT help with muscle loss and belly fat?

TRT can support muscle gain and fat loss, especially when combined with resistance training and proper nutrition. Studies in older men show improvements in lean body mass and reductions in fat mass with testosterone treatment. But TRT doesn’t build muscle or burn fat on its own. You still need to train hard, eat right, and sleep well. The hormone provides a more favorable environment, but the work is still on you.

What’s the difference between injections and gels?

Injections are less expensive (about 1/10 the cost), require less frequent dosing (weekly vs daily), but can cause more blood level fluctuations depending on what ester you are using. Gels provide more stable daily levels, avoid needles, but cost significantly more and carry risk of transfer to others through skin contact. Also the bioavailability is very low. The American College of Physicians recommends considering injections first due to lower cost and similar effectiveness.

How do I know if I have low testosterone?

Get blood work. Two separate morning blood draws (between 7-11 AM) showing total testosterone below 300 ng/dL plus symptoms consistent with hypogonadism (low libido, erectile dysfunction, fatigue, muscle loss, mood changes). Symptoms alone aren’t enough. Numbers alone aren’t enough. You need both.

What are the risks or side effects of TRT?

Common: acne, fluid retention, testicular shrinkage, mood changes. Serious: elevated hematocrit (increased blood clot risk), fertility suppression, potential worsening of sleep apnea, possible prostate growth. Hematocrit elevation affects 5-66% of men on TRT and requires monitoring. All risks are manageable with proper medical supervision.

How often do I need blood tests on TRT?

Initially: 3, 6, and 12 months after starting. Then at least annually if stable, more frequently if dose adjustments or side effects occur. Blood tests monitor testosterone levels, hematocrit, PSA, lipids, liver function, and other markers to ensure safety and efficacy.

Do you have to stay on TRT for life?

For many men, yes. Stopping TRT returns testosterone levels to pre-treatment (low) values and symptoms return. Some men successfully stop TRT and restart natural production with medications or lifestyle changes, but this is not guaranteed. Starting TRT is typically a long-term or lifelong commitment.

Is testosterone therapy covered by insurance?

Sometimes. Coverage varies widely by insurance plan. Generally requires documented diagnosis of hypogonadism with symptoms plus low testosterone on repeat testing. Some plans cover injections but not gels. Some require prior authorization. Some don’t cover it at all. Check with your insurance before starting treatment. Out-of-pocket costs for injections are relatively affordable; gels are expensive.

Should a 40-year-old man take testosterone?

Only if he has diagnosed hypogonadism (low testosterone levels plus symptoms) confirmed by proper testing and medical evaluation. Age alone doesn’t determine if you need TRT. Plenty of 40-year-old men have normal testosterone and don’t need treatment. Plenty of 60-year-old men have low testosterone and do need treatment. It’s individual.

What level of testosterone will a doctor prescribe TRT?

Generally below 300 ng/dL total testosterone on repeat morning testing, plus symptoms. Some clinicians use slightly different cutoffs (250-350 ng/dL range). The number matters less than the combination of low levels plus legitimate symptoms affecting quality of life.

The Bottom Line: Is TRT Right for You?

TRT is legitimate medical treatment for diagnosed hypogonadism. If you have confirmed low testosterone plus symptoms that significantly impact your quality of life, and you’ve ruled out other causes, TRT can be transformative.

But it’s not a shortcut. It’s not anti-aging magic. It won’t compensate for poor sleep, bad diet, no training, high stress, or excess body fat. It requires ongoing monitoring, carries real risks, and typically means lifelong commitment.

Before considering TRT:

  1. Get proper testing (two morning blood draws)
  2. Address fixable problems (sleep, body fat, training, stress, alcohol, vitamin D)
  3. Rule out other medical conditions (sleep apnea, thyroid, depression)
  4. Understand fertility implications if you want kids
  5. Find a qualified physician who will monitor you properly

If you do start TRT:

  • Commit to regular blood work and follow-up
  • Train consistently with progressive overload
  • Eat adequate protein and maintain appropriate calorie intake
  • Prioritize sleep and recovery
  • Monitor for side effects and report them immediately
  • Don’t expect overnight miracles

Whether you’re on TRT or going the natural route, strength training is the foundation for better body composition after 40. Get a plan built around your goals and recovery capacity.

TRT works when it’s appropriately prescribed and properly managed. Everything else is marketing, wishful thinking, or dangerous self-experimentation. Make the decision with your eyes open to both the benefits and the risks.

Maik Wiedenbach is a Hall of Fame swimmer turned bodybuilding champion and fitness model featured in Muscle & Fitness and Men’s Journal. An NYU adjunct professor and award-winning coach, he founded New York’s most sought-after personal training gym.