Regarding S&N Health patient policies:

We ask that you provide at least 24 hours notice if you need to cancel or reschedule an appointment at S&N Health. This allows us to offer the appointment slot to another patient in need of care.

We accept FSA/HSA payments. Please note that you are responsible for submitting any required claim notices, such as itemized invoices, to your respective institution. If you require an itemized copy, kindly inform us during your visit, and we will gladly accommodate your request.

If you have a medical emergency, please call 911 or go to the nearest emergency room. If you have a non-life-threatening medical concern regarding a medication we have prescribed for you, please call our office and we will do our best to fit you in for an appointment.

To become a new patient at S&N Health, you can call our office or use our online booking system to schedule an initial appointment. During your appointment, we will gather information about your medical history and discuss your healthcare needs.

We'll assist in tapering your medications to prevent weight regain. Certain meds like semaglutide & tirzepatide can be taken long-term to sustain progress. Maintenance requires ongoing lifestyle, diet, sleep, and health efforts akin to weight loss.

We examine your health thoroughly before starting any program for desired results due to medication contraindications. 

• "Hard no" cases include persons with atrial fibrillation, heart failure, and cases where patient decision-making ability is compromised. 
• The "weight loss shots" will not be provided to persons with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia.
• Hormone therapies will not be provided to persons with a history of prostate, breast, cervical, uterine, or vaginal cancers. 

These mentioned scenarios must follow up with their primary care provider for further treatment options regarding their health concerns. 

Weight loss therapy medications are only linked to medullary thyroid cancer and multiple endocrine neoplasia. Preliminary studies suggest a possible reduced risk of prostate cancer, but no significant research confirms this yet.

Providers fluently speak English, Thai, and Laos. You're welcome to bring a trusted translator if needed, but misinterpretations may occur. Exercise caution and choose translators wisely for accurate communication.

As healthcare providers, we advise all persons to be established with a primary care physician, but there is no requirement for an established primary care physician at S&N Health. Though, consultation findings and lab results may lead to referral to a primary care physician for further evaluation. 

That's okay. We'll order labs and direct you to a convenient location if necessary for your program.

Absolutely. Anyone is welcome to consult with us. We follow strict research-based protocols for our programs. While some cases may be deemed unfit to enroll, we will do our best to accommodate you.

You control who conducts your consultations. You can choose your provider based on their availability or select another if your preferred time isn't available.

Our programs are all-inclusive. Initial appointments are needed for a comprehensive health review, but follow-ups can be combined for convenience. For example, enrolling in Testosterone therapy and weight loss requires two initial appointments, but follow-ups can be combined. Note that follow-up appointments are limited to 15 minutes due to scheduling.

Our services are for everyone. Those with chronic inflammation, pain, or difficulty losing weight—such as individuals with thyroid issues, PCOS, Lupus, arthritis, anxiety, depression, stress, and hormonal imbalances—will benefit from our health optimization programs.

This medication is to be taken 30 minutes before engaging in sexual activity to address erectile dysfunction. Its effects can last up to 6 hours, with a usual decline in effectiveness after 3-4 hours.

This mediation is to be taken 30 minutes to 4 hours before engaging in sexual activity. Its effects can last up to 36 hours, providing the flexibility for spontaneity with your partner

This medication, like Sildenafil, is to be taken 30 minutes before engaging in sexual activity to address erectile dysfunction. Its effects can last up to 6 hours, with a usual decline in effectiveness after 3-4 hours.

Consider the following precautions before taking Viagra and Cialis, especially if:

• You are currently using sildenafil (Viagra) for pulmonary hypertension or erectile dysfunction.
• You use nitroglycerin patches or sublingual treatments, as it may cause a drop in blood pressure.
• You have experienced a heart attack, heart failure, or atrial fibrillation (A-fib) within the last 6 months.
• You have had a stroke in the past 6 months.
• You suffer from chronic kidney disease or liver disease; preliminary lab tests are necessary to ensure the medication's safety.
• You have a history of uncontrolled hypertension (high blood pressure).
• The healthcare practitioner deems this medication inappropriate for you based on your medical history, laboratory results, or examination findings.

Erectile dysfunction (ED) can result from various causes. In instances where ED is linked to low testosterone levels, correction may involve elevating testosterone through injections or pellets. Alternatively, treatment with medications like sildenafil, vardenafil, or tadalafil may be necessary in other cases to address erectile difficulties.

Indeed, sildenafil, vardenafil, and tadalafil are deemed safe when obtained from licensed compounding pharmacies that undergo FDA monitoring. While there are only a few contraindications for each medication class, we will thoroughly review these during your initial consultation to ensure that they are a suitable and safe option for you.

We offer "Scream Cream" for females experiencing decreased or absent orgasms. This medication is a vaginal application which is applied 30 minutes prior to sexual activity. "Scream cream" increases sensitivity and may enhance orgasm sensation. We offer both hormone-based and non-hormonal options of "Scream Cream." 

Females MUST have hormone labs and a mammogram within the last year before a prescription will be sent for a hormonal-based "Scream Cream."

Treatment options for low testosterone (low T) depend on the underlying cause, the severity of the condition, and individual factors such as age and overall health. Here are some common treatment options:

1. Testosterone Replacement Therapy (TRT): This is the most common treatment for low T. It involves administering testosterone through injections, patches, gels, or pellets. The goal is to raise testosterone levels to normal range and alleviate symptoms.
2. Transdermal patches: Patches containing testosterone are applied to the skin, typically on the back, abdomen, upper arm, or thigh. The hormone is absorbed through the skin and into the bloodstream.
3. Topical gels: Testosterone gels are applied to the skin, usually on the upper arms, shoulders, or abdomen. They are absorbed through the skin and into the bloodstream.
4. Intramuscular injections: Testosterone injections are administered into a muscle, usually every 1 to 2 weeks. This method provides a sustained release of testosterone into the bloodstream.
5. Subcutaneous pellets: Testosterone pellets are implanted under the skin, typically in the buttocks or abdomen, during a minor surgical procedure. The pellets gradually release testosterone over several months.
6. Oral medications: While less common, some oral medications may be prescribed to stimulate testosterone production or address underlying causes of low T. However, oral testosterone replacement therapy is less preferred due to potential liver toxicity and fluctuations in hormone levels.
7. Lifestyle changes: In some cases, lifestyle modifications such as weight loss, regular exercise, healthy diet, stress reduction, and adequate sleep can help improve testosterone levels naturally, especially if obesity or lifestyle factors contribute to low T.
8. Treatment of underlying conditions: If low testosterone is caused by an underlying medical condition, such as hypogonadism or a pituitary disorder, addressing the underlying cause may help restore testosterone levels.

Currently, there are no 'proven' significant health risks to not treating low T. However, you are leaving yourself at risk for developing unwanted effects such as hair loss, erectile dysfunction, depression, anxiety, & weight gain. Weight gain can lead to hypertension (high blood pressure) which has been proven to cause chronic diseases that are lifelong and must be pharmaceutically managed. 

Studies show that natural testosterone production can increase with strength training, proper diet, reduced alcohol intake, and 7-8 hours of quality sleep. Most testosterone is produced during REM sleep, which occurs every 80-100 minutes. The body needs 3-5 REM cycles for optimal rest and testosterone production.

Testosterone replacement therapy (TRT) can have both positive effects, such as alleviating symptoms of low testosterone, and potential side effects. The side effects can vary from person to person and depend on factors such as dosage, administration method, individual response, and pre-existing health conditions. Here are some common side effects associated with testosterone treatment:

1. Acne: Testosterone can stimulate oil glands in the skin, leading to acne outbreaks, especially in individuals prone to acne.
2. Fluid retention: Some people may experience fluid retention, leading to swelling in the ankles or feet.
3. Breast enlargement (gynecomastia): Testosterone can be converted into estrogen in the body, which may lead to breast tissue enlargement in some men.
4. Testicular shrinkage: Exogenous testosterone can suppress the body's natural production of testosterone, which may lead to testicular shrinkage. However, this is usually reversible once TRT is discontinued.
5. Sleep apnea: Testosterone replacement therapy can exacerbate or contribute to sleep apnea, a condition characterized by pauses in breathing during sleep.
6. Increased red blood cell count (polycythemia): Testosterone therapy can stimulate the production of red blood cells, which may increase the risk of polycythemia, a condition characterized by an elevated red blood cell count.
7. Decreased sperm count and fertility: TRT can suppress sperm production, leading to a decrease in sperm count and fertility. This effect is usually reversible upon discontinuation of testosterone treatment, but it's important to consider if fertility is a concern. Note, TRT does not change the structure of sperm or effect it's role in procreation. However, TRT interrupts the feedback process for sperm production, thus causing fewer active sperm and decreasing the chance of conception due to a lower sperm count versus structural infertility. Structural infertility must be followed up by a fertility specialist. 
8. Mood changes: Some individuals may experience mood swings, irritability, or increased aggression while on testosterone therapy.
9. Prostate enlargement or cancer risk: There is ongoing debate and research regarding the potential risks of testosterone therapy on the prostate gland. Some studies suggest that testosterone therapy may increase the risk of prostate enlargement (benign prostatic hyperplasia) or prostate cancer, while others have not found a significant association.