Conditions · Low Testosterone
Flat energy, low drive, brain fog, softer strength, stubborn belly weight — it’s not “just getting older.” In Fredericksburg, VA, we run the complete picture and optimize with physician-guided therapy. Start with an initial appointment.
True You evaluates low testosterone in men and offers testosterone replacement therapy (TRT) when it is clinically appropriate, at 904 Princess Anne St, Suite 207 in downtown Fredericksburg. Brian C. Hoff, MD begins with a 60-minute appointment, symptoms and history, and a full hormone work-up. Diagnosis rests on symptoms plus repeated blood tests, not one number.
We are cash-based and do not bill insurance. Costs are explained at your consultation.
Low testosterone shows up as fatigue, low motivation, poor focus, declining strength, weight gain, and low libido — but a one-off total-testosterone reading rarely tells the whole story.
At True You, Dr. Hoff evaluates free and total testosterone alongside the hormones and metabolic markers that influence them, then builds a monitored, physician-guided optimization plan designed to get your energy, drive, and edge back.
Why “in range” isn’t the goal
The difference is what gets measured — and against which range.
The conventional visit
The True You approach
Reference ranges are wide — a value can be “in range” yet far from optimal, which is why so many men feel off with “normal” testosterone.
Running on empty, with drive and get-up-and-go gone.
Reduced desire and performance that’s affecting life.
Harder to build muscle, easier to gain belly fat.
Cloudy focus and sleep that no longer restores you.
Testosterone tends to decline gradually, so the changes are easy to explain away: you’re busy, you’re tired, you’re getting older. But low testosterone can show up as fatigue, lower motivation and confidence, irritability, trouble concentrating, poorer sleep, reduced strength and recovery, more belly fat, and lower libido or changes in erections.
None of these symptoms prove low T on their own — thyroid problems, poor sleep, insulin resistance, and stress can cause similar changes. That’s why the answer starts with proper testing, not a guess.
Age plays a role, but it’s rarely the whole story.
Levels gradually decline from early adulthood on.
Excess body fat and high insulin are closely tied to lower testosterone.
Learn moreShort or disrupted sleep can lower testosterone production.
Sustained stress and high cortisol work against healthy levels.
Thyroid and pituitary signals influence how much testosterone you make.
What testing includes
When symptoms and repeat labs both point to low testosterone, testosterone replacement therapy (TRT) can help restore energy, drive, strength, and libido. Dr. Hoff considers your age, health history, and goals — including whether you plan to have children, since testosterone therapy can reduce fertility — before recommending a plan.
Once you start, we track your labs and how you feel and adjust over time. Where lifestyle factors like sleep, weight, or stress are lowering your levels, we work on those too, so therapy isn’t carrying the whole load. Your first visit and labs are in person at our Fredericksburg office; many follow-ups can be virtual.
How it works
Straightforward, thorough, and physician-led.
Step 1
An in-person visit in downtown Fredericksburg to talk through your symptoms, sleep, training, and goals.
Step 2
Total and free testosterone, SHBG, related hormones, thyroid, and metabolic markers.
Step 3
Dr. Hoff explains your numbers in context and whether TRT, lifestyle changes, or both make sense.
Step 4
If you start therapy, regular labs and check-ins — many virtual — to keep you on track.
Online clinics can make testosterone easy to get, but easy isn’t the same as safe. A good plan starts with confirming low testosterone on repeat testing, ruling out other causes, understanding your goals — including fertility — and committing to follow-up monitoring. That’s how we do it at our downtown Fredericksburg office, for men across Stafford, Spotsylvania, King George, and the region.
Low T is often one piece of a bigger picture.
Testosterone therapy is a long-term medical treatment, and it needs follow-up. We follow testosterone levels, blood counts, and prostate markers on a schedule suited to your plan. We also check blood pressure and ask about sleep, because untreated sleep apnea is a concern.
Testosterone can raise red blood cell counts, which is why blood counts are followed. It reduces sperm production, so if you want to father children now or soon, tell us before we start, since a different approach may be needed. It is not appropriate for everyone, including men with certain prostate or breast conditions.
Testosterone can be given by injection, topical gel or cream, and by pellets placed under the skin, among others. Each has trade-offs for steadiness, convenience and side effects. Dr. Hoff explains the options and recommends one for you. If a form matters to you, ask when you call.
How it works
A proper diagnosis comes first.
Step 1
Symptoms, history, medications, sleep, weight, and what you want to change.
Step 2
Testosterone (total and free), SHBG, estradiol, thyroid, blood sugar, blood counts and prostate markers. Testosterone is often repeated to confirm a pattern.
Step 3
Dr. Hoff explains what the results show, and whether they, with your symptoms, support treatment.
Step 4
If you decide to treat, we begin with a conservative dose.
Step 5
Follow-up labs and a conversation about how you feel, after the first several weeks.
Step 6
Regular monitoring, many visits virtual.
It depends on the work-up and the plan. We are cash-based, there is no insurance billing, and we explain the cost of yours at the consultation before you begin.
Online testosterone services are easy to find. The question is what happens before and after the prescription: whether anyone looks at your whole history, repeats the test, checks your blood counts, and answers the phone when something changes. At True You, a physician does all of that. Sometimes the answer is that testosterone is not the problem, and thyroid, sleep, weight or blood sugar is.
Men travel from across the region for a complete work-up and then follow up by video.
Our office is at 904 Princess Anne St, Suite 207, in downtown Fredericksburg, open Monday through Friday, 9:00 am to 5:00 pm. We serve patients in Fredericksburg, Falmouth and Stafford, Spotsylvania Courthouse and the rest of Spotsylvania County, Locust Grove, Lake of the Woods and Orange, and King George. The first visit and lab work are in person; many follow-ups can be done by video. Book an appointment or call (540) 701-0407.
Explore related care
Physician-guided testosterone optimization (TRT/BHRT), precisely dosed and monitored.
Learn more
The metabolic driver behind stubborn belly weight and energy crashes.
Learn more
Physician-guided, metabolic weight loss when body composition won’t shift.
Learn moreBook an appointment with Dr. Hoff’s team in Fredericksburg, VA.
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Read articlePatient reviews
Rated 4.7 from 46 Google reviews
“The people at True You helped save my life . They have been so supportive from the very first call. Dr. Hoff found the underlying issue that was affecting my health. I had bounced from one primary care office to another and from specialist to specialist, wasting money on copays along the way! I walked into their office with genuine concern about where my health was headed and what the rest of my life would look like. I now feel better than I have in over 20 years! I take any health concern to Dr. Hoff first. My biggest concern used to be whether I would be able to live well enough to remain an active part of my family. Now, my only concern is whether they can keep up with me! Thank you, Dr. Hoff and Tina Hoff! Not only will I get to enjoy watching my grandkids grow up, but I'll also be able to get around and chase them down, too! God bless you both!”
“Dr Hoff goes above and beyond to listen to you and respond with a program that can truly change your life. He’s very down to earth, easy to talk to, a wealth of knowledge, and genuinely cares about improving your life experience. I wish I would’ve found him and his staff sooner. I would give six stars if it were possible, thank you!”
“Dr. Hoff has truly changed my life in less than six months. I went from waking up every morning feeling miserable and constantly bloated to now feeling healthy, energized, and excited to take on each new day and experience life again. More importantly, I genuinely believe he is helping save my life in the long run by focusing not only on treating symptoms, but on improving my overall health and quality of life. Dr. Hoff is exceptionally knowledgeable and highly skilled in his field, but what truly sets him apart is the genuine care and compassion he shows his patients — something that has become far too rare in healthcare today. I’m also incredibly grateful for the entire staff and everyone there for creating an environment where patients feel heard, supported, cared for, and truly valued.”
Reviews shown as published on our Google Business Profile.
