I'm 45, tired, gaining weight and moody. Is it HRT, a GLP-1, my thyroid, or something else?

A clinic should evaluate you first, with a medical history, an exam and tests that look for other causes (thyroid tests, for example), before it prescribes anything. If perimenopause or menopause is behind your symptoms, the 2022 position statement from The Menopause Society finds a favorable benefit-risk ratio for hormone therapy in women who have no contraindications and are either under age 60 or in the first 10 years after menopause onset. The benefits it names are bone loss prevention and relief from bothersome hot flashes and night sweats ( The Menopause Society, 2022 ). Ask whether the clinic offers FDA-approved hormone products, and, if it recommends pellets or compounded products instead, why.

Do bioidentical hormones carry less risk than conventional HRT?

The word "bioidentical" describes a hormone that is chemically identical to one your body makes, and certain FDA-approved products qualify. The Prometrium label, for instance, describes its progesterone as identical in chemical structure to progesterone made by the human ovary ( DailyMed, Prometrium label ). What matters more is whether a product is FDA-approved or compounded . In 2020 the National Academies reviewed compounded bioidentical hormone therapy and reported that rigorous evidence of its safety and effectiveness from well-designed clinical studies was lacking. It described the wide use of these products as a concern for public health ( FDA summary of the NASEM report ).

What have medical societies said about hormone pellets?

Two sources bear on this. The Global Consensus Position Statement of 2019, which covers testosterone for women, does not recommend any testosterone preparation that pushes levels above normal (supraphysiologic), pellets and injections included. It also cannot recommend compounded bioidentical testosterone for low sexual desire, because the evidence for efficacy and safety is missing ( Global Consensus Position Statement, JCEM 2019 ). In a 2020 review, the National Academies urged FDA's compounding advisory committee to weigh every compounded bioidentical hormone pellet for the list of drugs that are difficult to compound ( National Academies review ). If a clinic suggests pellets, ask why it would not use FDA-approved pills, patches or gels instead, which hormone levels it will track, and what happens when the dose turns out excessive.

What did the Women's Health Initiative (WHI) show about hormone therapy?

In the 2002 WHI trial, women aged 50 to 79 took either conjugated equine estrogens with medroxyprogesterone acetate or a placebo. Women on the hormones had more invasive breast cancer, coronary heart disease, stroke and pulmonary embolism, but less colorectal cancer and fewer hip fractures ( Rossouw et al., JAMA 2002 ). Follow-up across 18 years of the WHI trials later showed no link between hormone therapy and higher death rates from any cause, cardiovascular disease or cancer ( Manson et al., JAMA 2017 ). The Menopause Society's 2022 statement judges the benefit-risk balance favorable for women who have no contraindications and are under 60 or within 10 years of menopause onset, for bothersome hot flashes, night sweats and bone loss prevention ( The Menopause Society, 2022 ).

How do I tell whether I truly need testosterone therapy as a man in my 40s?

The Endocrine Society's 2018 guideline says to diagnose low testosterone only when a man has consistently low levels together with symptoms and signs of deficiency, as confirmed by a repeat morning fasting total testosterone test , and then to look for the cause ( Endocrine Society guideline, 2018 ). The same guideline advises against starting testosterone for men who plan fertility soon, and for men with a heart attack or stroke in the last 6 months, untreated severe sleep apnea, an elevated hematocrit, or breast or prostate cancer ( Endocrine Society guideline, 2018 ). Before it prescribes, ask whether the clinic repeats the test, hunts for a cause and screens for these conditions. For heart-risk context, the TRAVERSE trial enrolled men aged 45 to 80 who had low testosterone along with heart disease or high heart risk. Against placebo, testosterone was noninferior on major cardiac events, yet atrial fibrillation, acute kidney injury and pulmonary embolism occurred more often ( Lincoff et al., NEJM 2023 ).

Is compounded semaglutide or tirzepatide still available in Austin in 2026?

FDA ruled the tirzepatide shortage resolved on October 2, 2024, and confirmed that again on December 19, 2024. For semaglutide, the shortage was ruled resolved on February 21, 2025 ( FDA ). Once a shortage ends, FDA generally treats the drug as commercially available. A 503A compounding pharmacy then may not regularly or in inordinate amounts compound essentially copies of it. The exception is a case where the prescriber decides and documents a significant difference for a specific, identified patient. FDA states that for 503A pharmacies the temporary grace periods on enforcement have ended for both drugs ( FDA ). In February 2026, FDA announced plans to restrict GLP-1 ingredients used in compounded drugs that FDA has not approved ( FDA ). On manufacturer self-pay pricing, Lilly lists Zepbound at $299 monthly for the 2.5 mg dose and $399 for 5 mg. The 7.5 mg to 15 mg doses cost $449, but only when refilled within 45 days ( Lilly ). Through NovoCare, Novo Nordisk lists Wegovy pens for $349 a month at standard doses, while Wegovy pills run $149 to $299 monthly ( NovoCare ). By both companies' account, these prices stay in effect through December 31, 2026.

May a clinic's pharmacy compound BPC-157 or CJC-1295?

Compounding from a bulk ingredient is open to a 503A pharmacy only when the ingredient has a USP or NF monograph, is part of an FDA-approved drug, or appears on FDA's 503A bulks list. Until that list is complete, FDA permits Category 1 substances ( FDA ). FDA put substances where it sees a possible significant safety risk into Category 2. Melanotan II, AOD-9604, thymosin alpha-1, TB-500, CJC-1295 and BPC-157 were once there, and the people who nominated them later withdrew the nominations ( FDA ). As of the list's May 14, 2026 update, none of them appears in Category 1 ( FDA category list ). Ask whether the clinic's product is an FDA-approved drug. If it is not, ask which pharmacy compounds it and why.

How does Texas regulate IV vitamin drips?

Jenifer's Law , Texas HB 3749, was signed on June 20, 2025 and took effect September 1, 2025 ( Texas Legislature ). The law applies to elective IV therapy, meaning IV fluids, nutrients, medications or blood that a patient asks for to ease temporary discomfort or improve temporary wellness. The physician can hand off prescribing or ordering to a PA or APRN, and administering to a PA, APRN or RN, all under adequate physician supervision ( HB 3749 text ). Before you book, ask what the drip is meant to accomplish, what evidence supports it, and who supervises.

Which checks should come before a testosterone or GLP-1 prescription?

For men on testosterone, the Endocrine Society calls for a repeated morning fasting total testosterone test, free testosterone when total testosterone is close to the low end of normal, and a search for the cause. Before treatment starts, the clinic should also screen for conditions that rule it out, such as an elevated hematocrit or a PSA above 4 ng/mL ( Endocrine Society guideline, 2018 ). For Wegovy (semaglutide), the label says it must not be used by anyone with MEN 2 or a personal or family history of medullary thyroid carcinoma, so the clinic should raise that history with you ( Wegovy label ). Whatever you are prescribed, ask which tests the clinic will order first and when it will go over the results with you.

Which warning signs should I look for when picking an Austin wellness clinic?

Check these before you book: who the supervising physician is for IV therapy ( HB 3749 ); whether pellets are offered to women with no mention of FDA-approved alternatives ( Global Consensus Position Statement ); whether the menu includes peptides that FDA has not placed in Category 1 (BPC-157 is one) ( FDA ); whether compounded semaglutide or tirzepatide is offered with no documented, patient-specific reason ( FDA ); whether a repeat of the morning fasting test comes before any testosterone prescription ( Endocrine Society ); whether a practitioner-patient relationship is established with you, by a physician or by a PA or APRN acting under the physician's delegation, before a delegated procedure ( 22 TAC §169.26 ); and whether the delegating physician's name and Texas license number are posted ( 22 TAC §169.28 ).

HRT in Austin, TX: Hormone Therapy, TRT & Semaglutide

Name: Med Spas of Austin
Price range: Free

Overview

Hormone and wellness care, in one place

Two women who both search “hormone therapy” could need very different things: a vaginal estrogen, a GLP-1 drug for weight, a thyroid workup, or FDA-approved estradiol plus progesterone. So this page covers a category of care rather than one procedure, and it is organized by the concern you walk in with, so you can decide what to raise with a clinician.

The longest sections cover hormone therapy for women, testosterone therapy for men and the GLP-1 drugs used for weight loss. Thyroid care, peptides and IV therapy get shorter treatment. Two Texas measures come up: a Texas Medical Board rule and a state law. On January 9, 2025, the Texas Medical Board’s rules for delegating cosmetic procedures took effect (Texas Medical Board). On September 1, 2025, Texas HB 3749 took effect; it covers elective IV therapy (Texas Legislature).

Detail	Summary
Austin cost	No Austin price range for these therapies is listed on this site. The GLP-1 section gives what the manufacturers charge self-pay patients for Wegovy and Zepbound.
Prescriber’s first step	A medical history and tests that fit the therapy
Follow-up	Continuing; under testosterone guidance, the first check comes at 3 to 12 months and then once a year
Downtime	None, because treatment is ongoing

The concerns this page covers

Perimenopause and menopause. Common symptoms are night sweats, hot flashes, vaginal dryness, painful sex and poor sleep. The FDA-approved choices are low-dose vaginal estrogen for genitourinary symptoms, or systemic estrogen, which is paired with a progestogen when you still have a uterus (The Menopause Society, 2022).

Low testosterone in men. According to the Endocrine Society, the diagnosis fits only a man who has signs and symptoms of deficiency along with levels that stay low, as a repeated morning fasting total testosterone test shows (Endocrine Society guideline, 2018).

Weight and metabolism. Semaglutide’s brand names are Ozempic for type 2 diabetes and Wegovy for weight; tirzepatide’s are Mounjaro for type 2 diabetes and Zepbound for weight (Ozempic label; Mounjaro label; Wegovy label; Zepbound label). FDA declared both shortages over in 2024 and 2025, which limits what compounding pharmacies may now make (FDA).

Peptides, IV drips and NAD+. Several peptides that wellness clinics sell were at one point put by FDA in Category 2 for compounding, the group it uses for substances that may present significant safety risks (FDA).

Thyroid. Hypothyroidism is treated with levothyroxine. A boxed warning on thyroid hormone labels says not to use these drugs for weight loss or obesity (Synthroid label).

Start by naming your own concern. Then ask the clinic which condition it plans to treat and which tests back up that diagnosis before anything is prescribed.

Decision

Matching symptoms to a first conversation

A rough guide for your first appointment:

Your main symptoms	A good question to raise
Menopause-related hot flashes, night sweats or poor sleep	Menopause hormone therapy: systemic estrogen, plus a progestogen when you have a uterus
Painful sex or vaginal dryness after menopause	Low-dose vaginal estrogen, or another local option
Men with low libido, low energy or muscle loss	A testosterone evaluation: a repeated morning fasting test, plus a look for what is causing it
Weight gain	Medical weight loss: does your situation meet the labeled criteria for any FDA-approved GLP-1 drug?
Fatigue, feeling cold, weight gain	Thyroid testing

More than one of these can be true at once. Ask the clinic which it will address first, and why.

Women

Hormone therapy for women

What the WHI found

Reported in 2002, the Women’s Health Initiative (WHI) trial randomized women aged 50 to 79 to a placebo or to conjugated equine estrogens with medroxyprogesterone acetate. The hormone group saw more coronary heart disease, invasive breast cancer, pulmonary embolism and stroke, along with fewer hip fractures and less colorectal cancer (Rossouw et al., JAMA 2002). Over 18 years of later follow-up, researchers found hormone therapy in the WHI trials was not associated with higher death rates from cancer, cardiovascular disease or any cause (Manson et al., JAMA 2017).

In its 2022 position statement, The Menopause Society separates women by timing. If a woman has no contraindications and is younger than 60, or less than 10 years past menopause onset, it judges the benefit-risk ratio favorable for preventing bone loss and for bothersome night sweats and hot flashes. If she starts after 60, or more than 10 years after menopause onset, it says the ratio appears less favorable, since her absolute risks of stroke, coronary heart disease, dementia and venous thromboembolism are greater (The Menopause Society, 2022).

In November 2025, FDA started removing boxed-warning language on breast cancer, cardiovascular disease and probable dementia from the labels of menopausal hormone therapy. The endometrial cancer boxed warning stays on systemic estrogen-alone products (FDA).

FDA-approved hormone therapy

Systemic estradiol: examples include a spray (Evamist), gels (Estrogel, Divigel) and patches (Climara, Minivelle, Vivelle-Dot). According to The Menopause Society, risk depends on the type of hormone therapy, its route, dose, timing and duration, and on whether a progestogen is added (The Menopause Society, 2022).
Micronized progesterone: Prometrium’s labeled dose for preventing endometrial hyperplasia, in a postmenopausal woman with a uterus who is on estrogen, is 200 mg taken at bedtime on 12 days of every 28-day cycle (Prometrium label). Estrogen labeling notes that adding a progestogen reduces the risk of endometrial hyperplasia, a condition that can come before endometrial cancer (Vivelle-Dot label).
Vaginal estrogen for genitourinary syndrome of menopause: examples include Estring, Estrace cream, Imvexxy and Vagifem. If bothersome symptoms persist despite over-the-counter products, The Menopause Society’s recommendation is low-dose vaginal estrogen, or options such as oral ospemifene or vaginal DHEA (The Menopause Society, 2022).
Combination products: examples include CombiPatch, which pairs estradiol with norethindrone acetate, and Bijuva, which pairs estradiol with progesterone.

The Vivelle-Dot label lists who should not use estrogen: women with liver disease or impairment, active or past blood clots, a stroke or heart attack now or in the past, estrogen-dependent cancer, breast cancer now or in the past, or genital bleeding that is abnormal and undiagnosed (Vivelle-Dot label).

Compounded bioidentical hormone therapy

A “bioidentical” hormone is one with the same chemistry as a hormone your body produces, and some FDA-approved products fit that definition. Prometrium is one: its label says its progesterone has a chemical structure identical to the progesterone a human ovary makes (Prometrium label). The more useful line to draw is between FDA-approved and compounded. Reviewing compounded bioidentical hormone therapy in 2020, the National Academies reported a lack of rigorous evidence, from well-designed clinical studies, for its safety and effectiveness (FDA summary of the NASEM report). If a clinic offers you a compounded product, ask what makes an FDA-approved one unsuitable for you.

Pellet therapy

Pellets go under the skin and release hormone over a period of months. Testopel is an FDA-approved testosterone pellet for men; its labeled dose is 150 mg to 450 mg, repeated every 3 to 6 months (Testopel label). Because that labeling is for males only, a woman offered a pellet should ask whether the product has FDA approval.

The 2019 Global Consensus Position Statement on testosterone for women recognizes one use backed by evidence: hypoactive sexual desire disorder in postmenopausal women, diagnosed after a formal assessment. It recommends against any testosterone product, injections and pellets among them, that raises levels past the normal range (supraphysiologic), and says compounded “bioidentical” testosterone cannot be recommended to treat low sexual desire (Global Consensus Position Statement, JCEM 2019). In a separate 2020 review, the National Academies urged FDA’s compounding advisory committee to consider all compounded bioidentical hormone pellets for the list it keeps of drugs that are difficult to compound (National Academies, 2020).

If pellets are recommended, ask the clinic what makes them better than FDA-approved pills, gels or patches, which of your hormone levels it plans to test, how it responds to a dose that runs too high, and how a dose can be lowered after the pellet is placed.

Men

Testosterone replacement therapy for men

Who qualifies

Here is the sequence the 2018 Endocrine Society guideline lays out (Endocrine Society guideline, 2018):

Diagnose low testosterone only in men who have symptoms and signs of deficiency and whose levels are consistently low
Confirm it with a morning fasting total testosterone test, repeated
When total testosterone is near the bottom of the normal range, measure free testosterone
After deficiency is confirmed, look for the cause

No single fixed cutoff of 300 ng/dL appears in the guideline. For standardized assays, it cites 264 ng/dL as the lower limit of normal in healthy young men who are not obese (Endocrine Society guideline, full text). Testopel’s label likewise calls for confirming the diagnosis with morning testosterone measured on two or more separate days (Testopel label). Before you get a prescription, ask whether the clinic repeats the test and looks for a cause.

According to the guideline, testosterone should not be started in men planning fertility soon, or in men with any of these: thrombophilia, uncontrolled heart failure, a stroke or heart attack within the last 6 months, untreated severe sleep apnea, severe lower urinary tract symptoms, an elevated hematocrit, a palpable prostate nodule, breast or prostate cancer, or a PSA above 4 ng/mL (above 3 ng/mL in higher-risk men) that has not had urologic evaluation (Endocrine Society guideline, 2018). The guideline also suggests not prescribing testosterone routinely to every man aged 65 or older (Endocrine Society guideline, full text).

The TRAVERSE trial

The TRAVERSE trial took 5,246 men between 45 and 80 years old with high heart risk or heart disease, hypogonadism symptoms, and two fasting testosterone readings below 300 ng/dL. They applied either a placebo gel or a 1.62% testosterone gel each day, for a mean of 21.7 months of treatment (Lincoff et al., NEJM 2023).

Major cardiac events (nonfatal stroke, nonfatal heart attack or cardiovascular death) occurred in 7.0% of men on testosterone versus 7.3% on placebo, which made testosterone noninferior to placebo.
Pulmonary embolism, acute kidney injury and atrial fibrillation were more frequent in the testosterone group.

In February 2025, FDA recommended adding the TRAVERSE results to every testosterone label and removing the boxed-warning language on increased cardiovascular risk, and it required warnings about blood pressure (FDA). FDA requested further label changes in June 2026, including removal of the limitation of use on age-related hypogonadism (FDA).

FDA-approved testosterone forms

Injections: testosterone enanthate or cypionate; Xyosted, injected under the skin once a week (Xyosted label); and Aveed, a long-acting shot available only through a restricted REMS program, because it can cause pulmonary oil microembolism reactions (Aveed label)
Gels: AndroGel is one example
Oral capsules: Kyzatrex, Tlando, Jatenzo
Nasal gel: Natesto
Pellets: Testopel

Testosterone is classed as a Schedule III controlled substance (Testopel label). Prescribing or dispensing any controlled substance requires a federal registration (21 U.S.C. §822).

Monitoring

The Endocrine Society guideline calls for an evaluation 3 to 12 months after treatment begins, then every year. Hematocrit is measured at baseline, at 3 to 6 months and then yearly; if it rises above 54%, therapy is paused until it falls back to a safe level. For men who opt into prostate monitoring, a rectal exam and PSA follow 3 to 12 months after starting, and a urology referral is made for a confirmed PSA above 4 ng/mL or a PSA increase of more than 1.4 ng/mL within 12 months (Endocrine Society guideline, full text). Ask which of these tests the clinic will order, and how often.

Fertility

Men who plan to father children in the near term should not start testosterone, the Endocrine Society advises (Endocrine Society guideline, 2018). If children are in your plans, tell the clinic before anything is prescribed, and ask about a referral to a fertility specialist or urologist.

GLP-1

Medical weight loss and GLP-1 drugs

FDA-approved products

Semaglutide: Ozempic carries approval for type 2 diabetes (Ozempic label). Wegovy, available as a weekly injection or a daily pill, carries approval for adults who have obesity, or who are overweight with one or more weight-related conditions, among other uses (Wegovy label).
Tirzepatide: Mounjaro carries approval for type 2 diabetes (Mounjaro label). Zepbound carries approval for reducing excess body weight in adults who have obesity, or who are overweight with one or more weight-related conditions (Zepbound label).

What the main trials found

STEP 1 (semaglutide 2.4 mg, NEJM 2021): the trial enrolled adults without diabetes with a BMI of 30 or higher, or 27 or higher with a weight-related condition. At 68 weeks, mean body weight had changed by -14.9% with semaglutide versus -2.4% with placebo (Wilding et al., NEJM 2021).
SURMOUNT-1 (tirzepatide, NEJM 2022): at 72 weeks, mean weight change was -15.0% on 5 mg, -19.5% on 10 mg and -20.9% on 15 mg, compared with -3.1% on placebo. On those three doses, 85%, 89% and 91% of participants lost 5% or more of their body weight; on placebo, 35% did (Jastreboff et al., NEJM 2022).

In both trials, the most frequent side effects were gastrointestinal, and most were mild to moderate (Wilding et al.; Jastreboff et al.).

Compounded semaglutide and tirzepatide

FDA declared the tirzepatide shortage resolved on October 2, 2024, then confirmed it on December 19, 2024; the semaglutide shortage followed on February 21, 2025. For tirzepatide, the enforcement grace periods ran out on February 18, 2025 for 503A pharmacies and on March 19, 2025 for 503B outsourcing facilities. For semaglutide, they ran out on April 22, 2025 for 503A pharmacies and on May 22, 2025 for 503B facilities (FDA). A 503A pharmacy may still compound for an individual patient if the prescriber documents a significant difference for that person, but may not regularly or in inordinate amounts make what are essentially copies of the approved drug (FDA).

Compounded drugs reach the market without FDA review of their safety, effectiveness or quality. FDA has had reports of adverse events tied to compounded semaglutide and tirzepatide, including some that required hospitalization and some linked to dosing errors (FDA). FDA said in February 2026 that it plans to restrict GLP-1 ingredients in compounded drugs that it has not approved (FDA). If a clinic offers a compounded version, ask it to name the pharmacy that makes it and the patient-specific reason for using it.

Manufacturer self-pay prices

These are the self-pay prices the manufacturers publish, as checked on October 29, 2026. They are not what Austin clinics charge, and a clinic’s visit and lab fees are extra.

Zepbound KwikPen (Lilly): 2.5 mg is $299 a month, 5 mg is $399, and 7.5 mg to 15 mg is $449, a higher-dose price that depends on refilling within 45 days. Vials are also $299 a month. The Lilly savings card runs out December 31, 2026 (Lilly).
Wegovy (NovoCare): pens are $349 a month at doses up to 2.4 mg, and new self-pay patients get an introductory price of $199 a month on their first two fills of 0.25 mg and 0.5 mg. Wegovy HD 7.2 mg is $399 a month. Wegovy pills are $149 a month at 1.5 mg, $199 at 4 mg, and $299 at 9 mg or 25 mg. NovoCare plans to update its pricing after December 31, 2026 (NovoCare).

Safety

Wegovy and Zepbound must not be used by anyone who has MEN 2 or who has a personal or family history of medullary thyroid carcinoma, and each carries a boxed warning on thyroid C-cell tumors (Wegovy label; Zepbound label). Wegovy’s label also lists warnings for severe gastrointestinal reactions, acute pancreatitis, kidney injury from dehydration, gallbladder disease, low blood sugar, and pulmonary aspiration under deep sedation or general anesthesia. The label does not recommend Wegovy in severe gastroparesis and says to stop it 2 months or more before a planned pregnancy. If you are on it, let your anesthesia team or surgeon know before any procedure (Wegovy label).

In January 2026, FDA said its review found GLP-1 drugs did not raise the risk of suicidal behavior or thoughts, and it asked manufacturers to remove that warning from labels (FDA).

Peptides

Which bulk ingredients can a 503A compounding pharmacy use? Only ingredients that have a USP or NF monograph, that are part of a drug FDA has approved, or that appear on FDA’s 503A bulks list. Until that list is finished, FDA allows the substances it has placed in Category 1 (FDA).

FDA uses Category 2 for substances it considers a possible significant safety risk. BPC-157, CJC-1295, TB-500, thymosin alpha-1, AOD-9604, GHK-Cu (injectable), melanotan II and Epitalon were once in that category before their nominators withdrew them. Ibutamoren and kisspeptin-10 are in Category 2. For several of these, FDA’s page points to limited safety data and possible immunogenicity, and for some, CJC-1295 and AOD-9604 among them, it reports serious adverse events (FDA). None of them is in Category 1 on FDA’s list as updated May 14, 2026 (FDA category list).

One FDA-approved peptide is Egrifta (tesamorelin), approved for reducing excess abdominal fat in adults who have HIV with lipodystrophy (Egrifta WR label).

For any peptide, ask whether it is an FDA-approved drug. If the answer is no, ask which pharmacy compounds it and on what grounds.

IV Therapy

IV therapy and NAD+

Jenifer’s Law, Texas HB 3749, was signed into law on June 20, 2025, with an effective date of September 1, 2025 (Texas Legislature). Under the law, elective IV therapy means IV fluids, nutrients, medications or blood that a patient requests to ease temporary discomfort or to improve temporary wellness. Prescribing or ordering can be delegated by a physician to a PA or APRN, and administration to an RN, PA or APRN, in each case under adequate physician supervision (HB 3749 text).

The evidence behind specific wellness drips, vitamin cocktails or NAD+ infusions is not graded on this page. Ask the clinic what the drip should do for you and what evidence backs that use, and ask who will place your IV, who will monitor you, and who the supervising physician is.

Thyroid

The standard treatment for hypothyroidism is levothyroxine. Thyroid hormone labels, levothyroxine (Synthroid) and liothyronine (T3, Cytomel) among them, have a boxed warning that these drugs are not for treating obesity or for weight loss. For people whose thyroid works normally, typical doses do not lower weight, and bigger doses can cause serious or even life-threatening toxicity (Synthroid label; Cytomel label). Per the levothyroxine label, overtreatment can also reduce bone mineral density and may cause arrhythmias, particularly in people with heart disease and in older patients (Synthroid label).

If a clinic suggests thyroid hormone, ask which of your test results show the need for it and how your dose will be tracked.

Texas Law

Texas rules to know

The Texas Medical Board’s rules on delegating nonsurgical medical cosmetic procedures, 22 TAC Chapter 169, Subchapter E, took effect January 9, 2025 (Texas Medical Board). They apply to cosmetic procedures such as injectables, not to hormone or GLP-1 prescribing generally. In short:

Before any delegated procedure, the patient must have a practitioner-patient relationship established by a physician, or by a PA or APRN acting under the physician’s delegation (22 TAC §169.26).
While the procedure is under way, a physician, PA or APRN has to be on site, or immediately available for emergency consultation (22 TAC §169.26).
Delegation is made by a written order that names the delegating physician and covers screening of patients, appropriate care, and what to do about complications and emergencies (22 TAC §169.27). The person performing the procedure must also sign and date a written protocol (22 TAC §169.26).
The delegating physician’s name and Texas license number must be displayed in every public area and treatment room (22 TAC §169.28).

Elective IV therapy falls under HB 3749, covered in the IV section above (HB 3749 text).

Before a cosmetic injection or IV drip at an Austin wellness clinic, confirm these three things:

You can see the delegating physician’s name and Texas license number posted (22 TAC §169.28)
A physician, or a PA or APRN acting under the physician’s delegation, has established a practitioner-patient relationship with you before any delegated procedure (22 TAC §169.26)
The person prescribing testosterone has a federal controlled-substance registration (21 U.S.C. §822)

What to Expect

The consultation, labs and monitoring

History. You can expect to be asked about sleep apnea, heart and clotting history, any family history of hormone-sensitive cancers, pregnancy plans, the medications you take now, and your medical history.

Tests. Which tests you get depends on the therapy. When a man is considering testosterone, the Endocrine Society recommends looking for the cause, measuring free testosterone if total testosterone sits near the low end of normal, and repeating a morning fasting total testosterone test. Hematocrit and PSA are also among the checks it lists before treatment begins (Endocrine Society guideline, 2018). Before prescribing a GLP-1 drug, the clinic should ask you about MEN 2 and medullary thyroid carcinoma (Wegovy label).

Monitoring. Testosterone patients are evaluated at 3 to 12 months and then every year, with hematocrit measured at baseline, at 3 to 6 months and then yearly (Endocrine Society guideline, full text). Women on menopause hormone therapy have the benefits and risks of staying on it reevaluated periodically (The Menopause Society, 2022). The Wegovy injection dose goes up every 4 weeks until it reaches maintenance (Wegovy label).

At any clinic, ask which tests will be ordered before a prescription and when the results will be reviewed with you.

Austin Pricing

Austin pricing

This page publishes no Austin price range for testosterone, hormone therapy, peptides, IV therapy or GLP-1 programs. Its only prices are the self-pay prices Lilly and Novo Nordisk publish for Zepbound and Wegovy, listed in the GLP-1 section (Lilly; NovoCare). Ask any clinic for its full price in writing, including the medication, labs and visits, and ask whether a contract is required.

How to Choose

Choosing a provider: what to check

Product sourcing.

GLP-1 drugs: is it compounded or FDA-approved? If it is compounded, what patient-specific reason has been documented (FDA)?
Hormones: is it compounded or FDA-approved? If it is compounded, what rules out an FDA-approved product for you (FDA summary of the NASEM report)?
Peptides: is it an FDA-approved product, and if it is not, does it sit in FDA’s Category 1 (FDA category list)?

Testing and monitoring.

Testosterone: does the diagnosis rest on a repeated morning fasting test and a look for the cause (Endocrine Society guideline, 2018)?
Testosterone: will hematocrit be checked at baseline, again at 3 to 6 months, and every year (Endocrine Society guideline, full text)?
GLP-1 drugs: will you be asked about MEN 2 and medullary thyroid carcinoma (Wegovy label)?

Credentials.

Is the delegating physician’s name and Texas license number on display (22 TAC §169.28)?
Before a delegated cosmetic procedure, does a physician, or a PA or APRN under the physician’s delegation, establish a practitioner-patient relationship with you (22 TAC §169.26)?
For IV therapy, who is the supervising physician (HB 3749 text)?

Warning signs.

Prescribing with no medical history or tests
Thyroid hormone sold as a weight-loss treatment (Synthroid label)
Peptides such as BPC-157 on the menu that are not FDA-approved and not in FDA’s Category 1 (FDA category list)
Compounded semaglutide or tirzepatide with no patient-specific reason documented (FDA)
Pellets offered to women without any mention of FDA-approved options (Global Consensus Position Statement, JCEM 2019)
Testosterone prescribed after one test, without a repeat or a search for the cause (Endocrine Society guideline, 2018)
No posted name or Texas license number for the delegating physician (22 TAC §169.28)

Treatment Areas

Areas treated

Menopause and perimenopause symptoms Vaginal and urinary changes after menopause (GSM) Low desire after menopause (HSDD) Male hypogonadism (low testosterone) GLP-1 drugs for medical weight loss Thyroid evaluation and care Peptide products Elective IV drips

Wellness & HRT in Austin