Men's Health
Men's Energy, Recovery & Hormonal Health Evaluation
Fatigue, poor sleep, slower recovery, or changes in how you feel can have many causes. A licensed provider can review your symptoms, health history, medications, and relevant lab results to identify appropriate next steps — which may include further testing, primary care referrals, lifestyle recommendations, or prescription therapy when medically appropriate and legally available.
Start a VisitAbout this evaluation
💬 Something has changed. Let's find out what.
Many men reach a point where something feels off — energy, sleep, recovery, mental sharpness, or motivation — but nothing on a standard check-up explains it. These symptoms are real, and they deserve a real clinical evaluation. The right starting point isn't a treatment — it's understanding what's actually going on.
A licensed provider can review your full symptom picture alongside your health history, medications, sleep, metabolic health, and relevant laboratory results. Depending on what that review suggests, next steps might include primary care follow-up, specialist referral, lifestyle recommendations, lab work, or — when clinically appropriate and legally available — discussion of prescription treatment options including compounded Sermorelin or injectable NAD+.
What this service provides
A licensed healthcare provider can evaluate common causes of fatigue, reduced recovery, sleep concerns, and other changes in wellbeing. When clinically appropriate, the provider may discuss compounded Sermorelin or injectable NAD+, including the limited evidence for the proposed uses, potential risks, alternatives, and the fact that these products are not FDA-approved. The right path may also be further testing, a referral, or a primary-care recommendation. MyPhysician360 does not manufacture, compound, dispense, ship, or sell medication. These compounded options should not replace evidence-based evaluation and treatment of underlying medical conditions such as sleep apnea, anemia, depression, diabetes, thyroid disease, cardiovascular disease, or confirmed hormone deficiency.
What we do and don't prescribe:
- →We may prescribe compounded Sermorelin when legally available and when a licensed provider determines it is clinically appropriate based on your individual history. Sermorelin is not FDA-approved for age-related wellness uses. This is a compounded medication; availability depends on current federal and state requirements and whether your selected pharmacy is able and legally permitted to prepare and dispense it.
- →We may prescribe injectable NAD+ when legally available and when a licensed provider determines it is appropriate. Injectable NAD+ is not FDA-approved for the general wellness and energy uses described on this page. Not all pharmacies can prepare or dispense compounded injectable NAD+; availability varies by pharmacy and state.
- →We do not prescribe testosterone, synthetic HGH, or controlled substances through this service. If you are looking for testosterone replacement therapy (TRT) evaluation, please speak with a specialist who can conduct the full clinical assessment TRT requires.
An important note about compounded medications
Sermorelin and injectable NAD+ are compounded medications — they are not FDA-approved products for the uses described on this page. The FDA does not verify the safety, effectiveness, or quality of compounded drugs before they are marketed. Compounded medications may meet an important need for individual patients when a licensed provider determines they are clinically appropriate and a pharmacy is able and legally permitted to prepare and dispense them. They are not the same as commercially available FDA-approved drugs, and the evidence for the specific uses described here is limited. Your provider will discuss this honestly with you during your visit.
When to consider an evaluation
📋 Symptoms worth evaluating — and what might be behind them
The symptoms below are common, nonspecific, and can have many causes. They are not diagnostic of growth hormone decline, low NAD+, or any particular hormonal condition. A licensed provider will consider a broad range of possibilities — including sleep disorders, thyroid disease, depression, anemia, diabetes, medication effects, low testosterone, cardiovascular disease, nutritional deficiency, and others — before discussing any treatment. Compounded Sermorelin or NAD+ should not replace evaluation and treatment of these underlying conditions.
Signs that warrant prompt specialist or in-person evaluation
Seek in-person or specialist evaluation before starting any treatment if you have: new severe or persistent headaches; vision changes or double vision; unexplained nipple discharge; multiple abnormal hormone results; a history of pituitary surgery, radiation, brain injury, or tumor; or excessive thirst with urination and neurologic symptoms. These may point to pituitary or neurologic disease that requires a different care pathway. Similarly, if you have loud snoring, witnessed pauses in breathing, nighttime gasping, marked daytime sleepiness, or suspected sleep apnea, sleep evaluation should happen before hormone-related treatment is considered.
| Symptom | Some possible causes worth evaluating |
|---|---|
| Persistent fatigue despite adequate sleep | Sleep apnea, thyroid disease, anemia, depression, diabetes, cardiovascular disease, medication effects, nutritional deficiency, overtraining, normal age-related changes, reduced physical activity |
| Poor sleep quality / not waking rested | Obstructive sleep apnea, anxiety, depression, alcohol use, poor sleep hygiene, chronic pain, medication effects |
| Slower recovery from exercise | Overtraining, inadequate nutrition or sleep, low testosterone, thyroid disease, metabolic conditions, normal age-related changes, reduced physical activity |
| Body composition changes | Dietary and lifestyle factors, low testosterone, thyroid disease, medication effects, metabolic conditions, sleep disruption, reduced physical activity |
| Brain fog and reduced focus | Sleep deprivation, depression, anxiety, thyroid disease, medication effects, nutritional deficiency, sleep apnea, cardiovascular risk factors |
| Low energy and motivation | Depression, chronic stress, sleep disorders, low testosterone, thyroid disease, anemia, metabolic conditions, medication effects, normal age-related changes |
| Reduced libido | Low testosterone, depression, medication effects, relationship factors, metabolic conditions, cardiovascular risk. See our Sexual Health & Performance page for ED-focused evaluation. |
The evaluation comes before the treatment
The goal of your visit is to understand what's actually driving your symptoms — not to match symptoms to a predetermined treatment. Many of the conditions listed above respond well to primary care management, lifestyle changes, or specialist referral. Compounded Sermorelin or NAD+ may be discussed when your provider determines they are appropriate for your specific clinical picture, after other causes have been considered.
A licensed provider can review your symptom picture and help determine appropriate next steps.
Start a VisitCompounded prescription option
💉 Sermorelin — what it is, how it works, and what you should know
Sermorelin is a synthetic 29-amino-acid analogue of growth hormone releasing hormone (GHRH) — the signal the hypothalamus uses to prompt the pituitary gland to release growth hormone. When a licensed provider determines it is clinically appropriate and legally available, Sermorelin may be prescribed as a compounded medication.
What you need to know before reading further
Compounded Sermorelin is not FDA-approved for age-related fatigue, body composition, sleep, athletic recovery, cognition, or general wellness. Evidence supporting its use for these purposes is limited and does not come from large, high-quality randomized controlled trials in generally healthy middle-aged adults. Adult growth hormone deficiency is a diagnosed medical condition that generally requires specialist evaluation and stimulation testing — it cannot be established based on fatigue, body composition, or aging alone. Your provider will discuss the limitations of the available evidence honestly during your visit.
How Sermorelin works:
- →It stimulates the pituitary gland to release growth hormone. Sermorelin binds to GHRH receptors in the pituitary and can stimulate the synthesis and release of growth hormone — provided the pituitary is capable of responding. It works through a different mechanism than direct growth hormone administration, which bypasses the pituitary entirely.
- →It is not the same as synthetic HGH. Recombinant human growth hormone directly replaces growth hormone and is FDA-approved for specific medical indications, including confirmed adult growth hormone deficiency. Sermorelin stimulates the pituitary to release its own GH and is not FDA-approved for wellness or age-related use. That different mechanism does not automatically make it safer or more effective than appropriately managed HGH for patients who need it.
- →Administration, dose, and timing depend on the prescribed formulation. Sermorelin is typically administered subcutaneously (under the skin) with a small needle. The specific instructions — including dose, timing, storage, and handling — depend on the formulation dispensed by the compounding pharmacy and your provider's clinical guidance. Follow only the instructions from your licensed provider and the dispensing pharmacy. Never transfer dosing instructions or supplies between pharmacies, as concentrations and formulations may differ.
Baseline laboratory testing:
Laboratory testing will commonly be needed before Sermorelin is considered. Depending on your symptoms and history, this may include IGF-1, glucose or A1C, thyroid function, kidney and liver function, and other relevant studies. These tests do not diagnose adult growth hormone deficiency by themselves. Suspected pituitary disease or true GH deficiency generally requires endocrinology evaluation and stimulation testing.
Possible risks and side effects:
- →Injection site reactions (redness, tenderness, swelling)
- →Headache, flushing, or dizziness
- →Fluid retention or swelling
- →Joint or muscle discomfort, numbness or tingling
- →Changes in glucose regulation — particularly relevant for patients with diabetes or insulin resistance
- →Elevated IGF-1 levels, which may require monitoring
- →Potential worsening of sleep apnea in susceptible individuals
- →The long-term risks of Sermorelin for age-related or wellness use are not well established
Sermorelin may not be appropriate if you have:
- →Active cancer, a recent cancer diagnosis, or ongoing oncology treatment — coordinate with your oncology team first; oncology coordination does not establish that treatment is proven safe
- →Certain pituitary disorders or pituitary tumors
- →Significant uncontrolled endocrine or metabolic disease (including poorly controlled diabetes or thyroid disorders)
- →Severe liver or kidney impairment
- →Pregnancy or breastfeeding
- →Age under 18
Eligibility is determined by your provider
Because compounded Sermorelin does not have an FDA-approved prescribing label for these uses, the above list reflects general clinical precautions rather than formal contraindications from an approved product label. Your licensed provider, in consultation with the dispensing pharmacy when appropriate, will determine whether Sermorelin is appropriate for your individual clinical situation.
Non-FDA-approved compounded option
⚡ NAD+ — what it is and what the evidence actually shows
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in virtually every cell in the body. It plays essential roles in energy metabolism, DNA repair, and the regulation of proteins involved in cellular aging. NAD+ levels appear to decline in some tissues with aging, though the degree of decline varies and is not routinely measured in clinical practice.
Honest assessment of the current evidence
The biology of NAD+ is supported by strong mechanistic research. However, evidence that compounded injectable NAD+ meaningfully improves energy, cognition, body composition, inflammation, immunity, cardiovascular health, or longevity in humans is currently insufficient to make confident clinical claims. Most human studies have evaluated oral NAD+ precursors (NR or NMN) rather than compounded subcutaneous injection. The absorption, pharmacokinetics, optimal dose, and clinical effectiveness of compounded subcutaneous NAD+ have not been well established in large human studies. Not all pharmacies can prepare or dispense compounded injectable NAD+; availability varies by pharmacy and state. Your provider will discuss this honestly with you.
What NAD+ does in the body — the established biology:
- →It is essential for cellular energy production. NAD+ functions as an electron carrier in mitochondrial metabolism — the process that converts nutrients into usable cellular energy (ATP). It is a required cofactor for this process.
- →It is required for the function of sirtuins and PARP enzymes. Sirtuins regulate metabolism, stress response, and circadian rhythm. PARPs are involved in DNA repair. Both require NAD+ to function. These are established biochemical roles, not proven clinical outcomes from supplementation.
- →It plays a role in immune cell signaling. NAD+ is involved in immune function pathways. The clinical implications of supplementation in healthy adults are not well established.
Safety information for injectable NAD+:
Safety, dosing, interaction, and long-term outcome data for compounded subcutaneous NAD+ are limited. Reported or possible reactions include the following, but this list may not be complete:
- →Headache, nausea, or flushing
- →Injection site reactions (redness, swelling, bruising)
- →Constipation or transient cramping during or after administration
- →Long-term safety is not well established for this route and use
⚠️ Seek emergency care for serious symptoms
Stop the medication and seek prompt medical evaluation for shortness of breath. Call 911 for severe breathing difficulty, facial or throat swelling, fainting, or other signs of a serious allergic or adverse reaction. Do not treat shortness of breath as a routine or expected side effect.
NAD+ precautions:
- →Patients with active cancer, recent cancer treatment, or significant cancer history require coordination with their oncology team before use. Oncology coordination does not establish that treatment is proven safe. The effects of NAD+-augmenting therapy on human cancer outcomes are not established.
- →Not for use during pregnancy or breastfeeding, or in children.
- →Drug-interaction information for compounded injectable NAD+ is limited. Report all prescription medications, over-the-counter products, supplements, and medical conditions to your provider and dispensing pharmacist.
- →Injectable NAD+ must be prepared using ingredients and processes appropriate for sterile compounding. Confirm product-specific questions about ingredient sourcing, sterility, storage, beyond-use dates, and supplies directly with your dispensing pharmacy.
- →Injectable NAD+ is a compounded medication and has not been FDA-approved for the uses described on this page. Availability depends on whether your selected pharmacy is able and legally permitted to prepare and dispense it.
How online care works
💻 What a telehealth hormonal health evaluation can do
A licensed provider can evaluate your symptoms, health history, and goals through a structured clinical visit. This is the starting point — not a pathway to an automatic prescription. The provider may determine that the right next step is something other than Sermorelin or NAD+, including lab work, primary care follow-up, or specialist referral.
| What telehealth can do | What may require additional steps or referral |
|---|---|
| Evaluate your symptom pattern, health history, medications, and goals through a structured clinical intake | Laboratory testing — IGF-1, glucose/A1C, thyroid, kidney and liver function — which will commonly be needed before Sermorelin is considered |
| Discuss whether compounded Sermorelin or injectable NAD+ may be appropriate, including honest discussion of evidence limitations and legal availability | Confirmed adult growth hormone deficiency evaluation — this generally requires specialist assessment and stimulation testing, not a telehealth evaluation alone |
| Prescribe compounded Sermorelin or injectable NAD+ when the provider determines this is clinically appropriate and the medication is legally available through your chosen pharmacy | Oncology coordination for patients with current or recent cancer history before either treatment is considered |
| Recommend lab work, primary care follow-up, or specialist referral when the evaluation suggests a more appropriate pathway | Endocrinology referral when suspected pituitary disease, significant thyroid disorder, or true GH deficiency is identified |
| Provide guidance on administration and follow-up in coordination with your dispensing pharmacy's product-specific instructions | In-person care when conditions require physical examination, diagnostic imaging, or procedures not available via telehealth |
- →🎯 Evaluation-first, always. A provider won't prescribe Sermorelin or NAD+ without understanding your full clinical picture. The visit is an evaluation — not a formality before treatment.
- →📋 Lab work will commonly be needed before Sermorelin. Depending on your history, your provider may recommend testing before prescribing. Follow-up monitoring may also be recommended.
- →⏰ Same-day initial visits may be available during operating hours, 8am–8pm ET every day. Laboratory testing or specialist evaluation may still be required before treatment decisions are made.
- →💰 No required membership. Pay per visit. No subscription needed to start.
What to expect
🗓️ Your visit, start to finish
Here's how a hormonal health evaluation visit works — from your initial symptom description to a clear clinical assessment and next steps.
|
1
Describe your symptoms and history
You'll answer questions about your energy, sleep, recovery, cognitive function, mood, body composition changes, and other relevant symptoms. You'll share your health history, current medications and supplements, any prior lab results, lifestyle factors, and your goals. Specificity here helps your provider give you a more useful clinical assessment. |
2
Clinical evaluation
Your provider reviews your intake and considers a broad range of possible causes before discussing treatment. They screen for conditions that may contraindicate Sermorelin or NAD+, and may recommend lab work before any prescription is issued. This is a real clinical evaluation — not an automatic approval. The evaluation may result in a referral, lab order, or primary care recommendation rather than a prescription. |
3
Assessment and next steps
Your provider explains their assessment and recommended path. If prescription treatment is appropriate, they'll discuss the treatment, its evidence limitations, administration guidance, and what to watch for. When a prescription is written, it is sent electronically to the pharmacy you choose. The pharmacy independently determines whether it is able and legally permitted to prepare and dispense the compounded medication. Availability, formulation, cost, and dispensing time vary by pharmacy. |
4
Follow-up and monitoring
Your provider is available for follow-up as your treatment progresses. Lab monitoring may be recommended at intervals based on your clinical picture. If your symptoms change significantly, new symptoms appear, or treatment is not going as expected, contact your provider. Do not adjust your dose or protocol without provider guidance, and never use dosing instructions or supplies from a prior prescription filled by a different pharmacy — formulations and concentrations can differ. |
Your prescription, your pharmacy
🏪 Your prescription. Your pharmacy choice.
MyPhysician360 does not manufacture, compound, dispense, ship, or sell medication. When a licensed provider determines that prescription treatment is appropriate, a prescription may be sent electronically to the pharmacy you select.
Sermorelin and injectable NAD+ are not FDA-approved products for the uses on this page. A pharmacy must independently determine whether it is able and legally permitted to prepare and dispense the prescribed compounded medication. Not every pharmacy can prepare or dispense these compounded injectable medications. Availability, formulation, concentration, cost, storage requirements, dispensing time, and whether the pharmacy ships or requires in-person pickup all vary by pharmacy and state. Injectable products must be prepared using ingredients and processes appropriate for sterile compounding — confirm product-specific questions about ingredient sourcing, sterility, storage, and beyond-use dates directly with your dispensing pharmacy. Follow your dispensing pharmacy's product-specific labeling, storage instructions, and handling guidance. A prescription does not guarantee that any particular pharmacy will fill the medication.
- ✓Prescription sent electronically to your chosen pharmacy when clinically appropriate
- ✓You may select a pharmacy — pickup or delivery options vary; not every pharmacy can fill these prescriptions
- ✓HSA and FSA eligible visits
- ✓No required membership to start a visit
- ✓If we can't help you online, you won't be charged
Frequently asked questions
❓ Questions about this evaluation and these treatments
Why doesn't this page cover testosterone replacement therapy (TRT)?
Testosterone is a controlled substance that requires a specific clinical evaluation, confirmed lab findings, and an ongoing monitoring protocol that differs significantly from the treatments on this page. TRT also carries distinct risks — including effects on fertility, cardiovascular health, red blood cell count, and natural testosterone production — that require careful management by providers who specialize in this area. This page focuses on hormonal health evaluation and, when clinically appropriate and legally available, compounded Sermorelin and injectable NAD+. If you are specifically interested in testosterone evaluation, we recommend working with a specialist who can conduct the full assessment and monitoring that TRT requires.
Is Sermorelin the same as HGH?
No. They work through different mechanisms. Recombinant human growth hormone directly replaces growth hormone and is FDA-approved for specific medical indications, including confirmed adult growth hormone deficiency. Sermorelin is a GHRH analogue that stimulates the pituitary gland to release its own growth hormone. Sermorelin is not FDA-approved for the wellness and age-related uses described on this page. Having a different mechanism than synthetic HGH does not automatically establish that Sermorelin is safer or more effective — the evidence for its use in healthy, aging adults is limited.
Can I be diagnosed with growth hormone deficiency through this telehealth visit?
No. Adult growth hormone deficiency is a diagnosed medical condition that generally requires specialist evaluation and — except in specific circumstances — growth hormone stimulation testing. It is not established based on fatigue, body composition changes, or aging alone. An IGF-1 result alone is also not sufficient to diagnose adult GH deficiency. If your evaluation suggests a possible pituitary disorder or true GH deficiency, your provider will refer you to an endocrinologist for appropriate assessment.
Will I need lab work before starting treatment?
For Sermorelin, yes — baseline laboratory testing will commonly be needed. Depending on your health history, this may include IGF-1, fasting glucose or A1C, thyroid function, kidney and liver function, or other markers. These tests do not diagnose adult GH deficiency by themselves. For injectable NAD+, monitoring standards are not yet standardized given the limited clinical evidence; your provider will determine whether baseline testing is appropriate for your situation.
What's the difference between injectable NAD+ and NAD+ supplements from a pharmacy or health food store?
Over-the-counter NAD+ precursors (such as NMN or NR) are supplements that the body converts to NAD+, and there is human evidence that they can raise NAD+ levels. Injectable NAD+ delivers the molecule subcutaneously as a compounded medication. The absorption, pharmacokinetics, optimal dose, and comparative clinical effectiveness of compounded subcutaneous NAD+ versus oral precursors have not been well established in large human studies. Your provider can help you assess the tradeoffs based on your specific situation, including whether a compounded injectable formulation is appropriate or whether other approaches might be considered.
Can I use Sermorelin and NAD+ at the same time?
The safety and effectiveness of combining compounded Sermorelin with injectable NAD+ for the goals described on this page have not been established in clinical studies. A provider will evaluate each therapy individually. Whether using both is appropriate for your situation depends on your health history, current medications, and clinical picture — your provider will assess this during your visit.
How do I know if Sermorelin or NAD+ is right for me?
You won't know before a clinical evaluation — and neither will we. The right path depends on your full symptom picture, health history, medications, relevant labs, and an honest provider assessment of what's most likely driving your symptoms. The evaluation may conclude that one of these treatments is appropriate, or it may point to something else entirely — lab work, a referral, a lifestyle recommendation, or a different care pathway. The visit is designed to find out what's actually going on, not to fit your symptoms to a predetermined solution.
Is this visit HSA or FSA eligible?
The visit may be eligible for HSA or FSA payment. Check with your plan administrator regarding eligibility and documentation requirements. Coverage or eligibility for compounded medications may differ from that for the visit itself.
Something has changed. Let's find out what.
A licensed provider will take the time to evaluate your full symptom picture — not just match it to a treatment. Whether the right path is a referral, lab work, lifestyle guidance, or a prescription when appropriate and legally available, the visit is designed to get you real answers.
HSA & FSA eligible | No required membership | No charge if we can't help
Medical disclaimer & sources: The information on this page is for general educational purposes only and does not constitute medical advice. Treatment requires clinical evaluation by a licensed provider; this page does not provide or imply a diagnosis. Sermorelin and injectable NAD+ are compounded medications — they are not FDA-approved for the uses described on this page. The FDA does not verify the safety, effectiveness, or quality of compounded medications before they are marketed. Evidence supporting the use of compounded Sermorelin or injectable NAD+ for fatigue, energy, sleep, athletic recovery, body composition, cognition, immunity, inflammation, or longevity is limited and does not come from large, high-quality randomized controlled trials in generally healthy adults. Adult growth hormone deficiency is a medical diagnosis that generally requires specialist evaluation and stimulation testing — it is not established by symptoms or IGF-1 alone. Patients with active cancer, recent cancer treatment, or significant cancer history should coordinate with their oncology team before using either treatment; oncology coordination does not establish that treatment is proven safe. MyPhysician360 does not manufacture, compound, dispense, ship, or sell medication. A pharmacy must independently determine whether it is able and legally permitted to prepare and dispense a prescribed compounded medication; not every pharmacy can fill these prescriptions; availability, formulation, cost, and dispensing time vary by pharmacy and state. These compounded options should not replace evidence-based evaluation and treatment of underlying medical conditions. We do not prescribe testosterone, synthetic HGH, or controlled substances. MyPhysician360 services are available in most states. Services are not currently available in Mississippi or Alaska.