Vitals & Voices
Welcome to Vitals and Voices, brought to you by Lexington Regional Health Center — your community, your health, your care. This is your trusted source for health-related content that matters to you.
Each episode, we bring you real conversations with the voices behind the care — from medical experts and wellness champions to community leaders and patients — sharing insights, stories, and tips to help you live your healthiest life.
Whether you're tuning in from Lexington or beyond, we're here to inform, inspire, and connect. Because at LRHC, your health is our priority — and your voice matters.
Vitals & Voices
More Than Just Low Energy: A Men’s Health Check‑In with Travis Barkmeier
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In this episode of Vitals & Voices, we sit down with Travis Barkmeier, Family Nurse Practitioner, to break down one of the most common—but most overlooked—topics in men’s health today: testosterone, energy, and overall hormonal wellbeing. Travis helps explain what symptoms really matter, why low testosterone is getting so much attention, and what men can expect from evaluation and treatment—including services available locally right here in Lexington.
Whether you’ve noticed changes in energy, mood, sleep, performance, or motivation—or you’re supporting someone who has—this conversation offers a clear, practical guide to understanding men’s health and hormone balance.
What You’ll Learn in This Episode:
- Why testosterone is a hot topic
- Common symptoms men shouldn’t ignore
- What actually causes testosterone changes
- How testosterone is evaluated
- What testosterone treatment really looks like
- Safety, side effects, and insurance basics
- Care close to home
- How to get started
Why This Episode Matters:
Men often delay care until symptoms are disruptive—or until a partner encourages them to be seen. But as Travis explains, changes in energy, sleep, libido, or motivation are not “just getting older.” They’re real medical symptoms with real, evidence‑based treatments available.
With trusted local providers, accessible testing, and personalized treatment options, men in our community don’t have to settle for feeling less than their best.
If you’re ready to understand how testosterone impacts your overall wellbeing—and what steps can help you feel more like yourself again—this episode is a powerful place to start.
Vitals & Voices is a podcast powered by Lexington Regional Health Center, offering meaningful health conversations that matter to you. Each episode features authentic stories and expert insights from the people behind the care — including healthcare professionals, wellness advocates, community leaders, and patients — all aimed at helping you live your healthiest, most informed life.
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Welcome to Vitals and Voices, brought to you by Lexington Regional Health Center. Your community, your health, your care. This is your trusted source for health-related content that matters to you. Each episode, we will bring you real conversations with the voices behind the care, from medical experts and wellness champions to community leaders and patients, sharing insights, stories, and tips to help you live your healthiest life. Whether you're tuning in from Lexington or beyond, we're here to inform, inspire, and connect. Because at LRHC, your health is our priority and your voice matters. Hello, everyone, and welcome back to today's episode of Vitals and Voices. Today we're talking about something really important: men's health, specifically energy levels, hormone health, and testosterone. We are joined by Travis Barkmeyer. He is one of our nurse practitioners to help us break down what is normal, what isn't, and what care options are available locally. Travis, thanks for being here.
SPEAKER_00Thanks for having me.
SPEAKER_01So if you want to start, Travis, by just telling our listeners a little about you, your role as a nurse practitioner, and how men's health kind of fits into that.
SPEAKER_00Yep. So just a little bit of my background. I actually grew up in Gothenburg just down the road. Um I practice as a family nurse practitioner. Practiced in Lincoln for about five years, and I've been here in Lexington now for 11 years. Um I do primary care, but also kind of have some subspecialties, um, one of them being men's health, testosterone replacement therapy.
SPEAKER_01And people might have seen you in the orthoclinic as well, too.
SPEAKER_00That's right. And another big part of my practice is uh orthopedics as well.
SPEAKER_01Okay. Well, that sounds good. So we're seeing, I know I personally am seeing a lot of ads and messaging around testosterone, men's health. It seems like they're every other commercial on some of the channels that you watch. So from a clinical perspective, why do you think this topic is getting so much attention right now?
SPEAKER_00Yeah, I think it's uh one of those things that, you know, we've supplemented women for, you know, years, you know, post-menopausal women. It's just become more mainstream for men to um, you know, actually seek care for some of these symptoms that may have been difficult to talk about. I think some of the, you know, whether it be the marketing and stuff like that, but it's just it's become a lot more mainstream. I think guys are a little bit more comfortable at least asking these questions at these visits.
SPEAKER_01Okay. Well, that's good to know. And just maybe, yeah, some of those symptoms and just resonating with patients to be like, hey, that this isn't normal as you age or things with that. Okay. So along those lines with symptoms, when men come in to see you, what kind of symptoms might prompt you to consider, hey, this might be a testosterone issue?
SPEAKER_00I think the biggest one that gets people in the door is that they just aren't feeling quite themselves. They might be fatigued. It might be that they go to work and they get home, they don't have any energy to, you know, play with the kids, go to the gym, that type of thing. Um, you know, some of the more difficult things to talk about, also, you know, libido, things like that are things that come up with these discussions.
SPEAKER_01Okay. Physical changes as well, too. So changes in their body, is it weight gain, muscle loss?
SPEAKER_00It can be a little bit of both. Um, it might be that, you know, they've put on some weight over the years. Also, maybe they've, you know, tried to, you know, fix some of those things, they're going to the gym, but they're not really putting on any of that lean muscle that they're hoping to.
SPEAKER_01Okay. So difficulty losing weight, I mean, could be a sign of testosterone.
SPEAKER_00Definitely.
SPEAKER_01Okay. Okay. Um, you hit on this a little bit, but does age mean testosterone will be low? Is it more complex? How, I mean, how does that affect a lot of different things?
SPEAKER_00Definitely doesn't necessarily mean we we do know that everybody's testosterone slowly decreases with age. Um, but at the rate that that happens is a pretty individualized thing. Um, doesn't mean that you're 60 and you're going to have low testosterone, but it also doesn't mean that you're 40 and that you know you definitely could be low at that age as well. So it's a it's an individualized thing.
SPEAKER_01And with that is sleep part of this? Is it stressful? I mean, what are you what are you seeing?
SPEAKER_00Yeah. So one of the things that we kind of one of those symptoms it's hard to categorize, but sometimes guys will come in and just be like, I just don't feel like myself. They can't really put a you know a finger on what exactly it is. Sometimes you hear the term kind of that brain fog. Um, that's something that can also be related to testosterone. Um, but also, you know, you kind of bring up sleep. That's not necessarily a symptom, but if patients aren't sleeping well, that definitely can affect testosterone levels.
SPEAKER_01Okay. That's good to know. High level overview, and you mentioned it brief briefly, but libido. Sexual health can be uncomfortable to talk about, but it's an important part of overall health. So do changes in libido or performance kind of fit into this conversation?
SPEAKER_00Yeah, it definitely can be one of the biggest ones, and it's probably the symptom that's most closely related to testosterone. Um, and and I think that's something, especially in my clinic, that, you know, my nurse is very familiar with is something that, you know, shouldn't be hard to talk about, even though sometimes it is, but she's very familiar with this. This is something that she hears about probably on a daily basis in her clinic. So it should be a pretty comfortable setting from that standpoint.
SPEAKER_01Good. Bring it up. We're here to talk about it. Normal part of life and something that if that's affected, that's I mean, could be a big part of your life with it.
SPEAKER_00For sure.
SPEAKER_01Um, so if someone's listening and they're wondering whether testosterone could be a part of what they are experiencing, how how do you evaluate that? They've come in with the symptoms. What are kind of those next steps?
SPEAKER_00Yep. I see a couple of different ways. Sometimes I'll have patients that will specifically come in wanting to look at, you know, those type of symptoms. Sometimes it might be that you're already a patient and it comes up in one of our normal exams. Um, but there's a couple of different ways to kind of get in. Like I said, it can be, you know, I might take care of you, you might have a primary care doctor, you might come in just specifically for testosterone related, you know, treatment. But also, like I said, it you could also become a primary care patient. We can deal with it that way as well.
SPEAKER_01Okay. And they come in, you think it might be that is it a blood test or kind of what is it to determine maybe what those levels look like?
SPEAKER_00Yep. It's it's kind of a it's a combination of things. We we have a couple questionnaires that we do. So we we want to kind of hear those subjective symptoms, kind of what you're feeling. But then ultimately it is a blood test that confirms if you are low or not.
SPEAKER_01And is there a a baseline for testosterone? Does it depend on age or how how do you evaluate that?
SPEAKER_00That's kind of the difficult part about testosterone replacement therapy. That's a lab test that is not part of like a routine physical when you're 18. We really don't know where you were at when you were kind of at that peak level. You know, just for uh a broad sake, you know, three to nine hundred is kind of that normal range, which is a really big range. Yeah. But we don't really know where you fell when you were 18. You know, and that's kind of the hard thing. So that's why we take, you know, your symptoms plus your lab work and kind of come up with a treatment plan that's specific to you.
SPEAKER_01And what is what do those follow-up appointments look like, or how often are you meeting or you're checking those levels to see if they're increasing?
SPEAKER_00So, you know, if we have your initial appointment, we find out that you're low, we kind of have a discussion on if you want to supplement or not. If we start you on something, typically it takes a little bit of time for that to build up. So we'll see you back in six or eight weeks. And then as we're going through dose adjustments, it's you know, a couple months. Um, you know, every couple months we'll have those visits. But once once we stabilize you on a dose, it's a couple times a year. So it's not a big burden that way, but we also want to make sure that we're keeping close tabs and that we've got you on the correct dose.
SPEAKER_01And what what does that dosing look like? Or kind of what are those treatment options if someone does have low, low testosterone?
SPEAKER_00So the most common form of supplementation is through injection. Um, it's an IM or an intramuscular injection that you do once a week. Um, most of our patients, um, you'll come back in. My nurse will kind of teach you how to do it properly, and you can do those at home. Um, or we do have the option if you want to come in each week, we can do those at the hospital as well. That's definitely arm or uh typically if you're doing it yourself, we have you do it in your leg just because it's easiest to see. Sure. Um, but yeah, otherwise, if you have a spouse or something that's comfortable, we can also teach uh him or her as far as like arm also and the gluteus muscle can be used as well.
SPEAKER_01Is there side effects with these? I mean, generally speaking, I know everyone's different, but been successful for a lot of patients.
SPEAKER_00Yeah, for the most part, it's uh very well tolerated. Uh, you know, minimal side effects as long as we keep you within that physiologic range. You know, that three to nine hundred is that normal and we're supplementing you. We usually try to keep you in that six to seven hundred mark somewhere around in there.
SPEAKER_01And so having that medical oversight, I mean, is huge to know. Do we need to adjust what that looks like?
SPEAKER_00And yeah, for sure. I think it's yeah, the you know, and that's the thing. There's lots of different supplements that you can get on the internet and look at and you know, buy. That's one thing I definitely advise patients to stay away from. You know, that's in the medical world, there is no oral testosterone, and and there that's for a reason because a lot of that stuff is hard on your liver. So all the stuff that you could take and buy over the counter, we tend to try to, you know, get you to stay away from that. You know, as far as the the IM injection is the most common form that we use as far as supplementation, but there are creams and gels. There is a trochea that dissolves under the tongue, but with all of those products, like I said, none of them are actually taken orally, and for that reason.
SPEAKER_01Okay. Um, does insurance cover most of these? If I mean, especially if it's it's warranted, you have the numbers to prove it. What what does that look like, generally speaking?
SPEAKER_00So generally speaking, that that part's kind of hit or miss. Um I I would say the majority of the time it's probably not covered. But if you if you are able to do the injectable method, it's pretty reasonable. I think most of our patients find that, you know, for $40, $50 a month you can supplement. Um, and then that's what would cost for the medicine part of it.
SPEAKER_01Oh, that's I mean, that's good to know. With that, too. I mean, not saying any names or anything like that, but generally speaking, what success have you seen in patients who have started this? How does their life look different?
SPEAKER_00Yeah. I think uh there are very few guys that, you know, truly, if we match up, you know, kind of their questionnaires, their symptoms with low blood work, very few guys that we supplement that don't see a significant improvement in all those symptoms. And and for the most part, the medicine's very well tolerated.
SPEAKER_01Do you think a lot of times it's they're coming in uh for these things? Is it a wife, a spouse, a friend that's sending them? You know, what does that look like?
SPEAKER_00Um, I I think it's a little bit of both. I I think we definitely see it from, you know, the girlfriend, the spouse, but also I think some of it is too, is just I mean, it's it's all over. It's it's every other commercial is a limitless mail or is you, you know, something, or whether they're talking about um, you know, Viagra, all that kind of ties into that. And I think it's just it's it's out there in a lot of different ways.
SPEAKER_01And it's good to know that I mean, patients can do it locally with someone who who has done this for years and years and who's here to who's here to help them. There's no need to drive hours away for something that can be done here, especially if you're yeah, going to be seen somewhat often or having those follow-up visits.
SPEAKER_00Yeah, I think that's kind of an important thing. I mean, you know, the limitless mail commercials are very common, and that's something that we can offer all of those services right here in town. That's nothing that you have to drive down the road for.
SPEAKER_01That's good to know. So an important thing for our listeners, um, are there other men's health services available right here? We can do testosterone replacement therapy. Is there any of those other ones that you want to highlight that are available locally?
SPEAKER_00I mean, I I think just anything in regards to men's health. I mean, I think we can pretty much offer all of those services. And if there's something that that you can't, we can definitely direct you in the right direction. And, you know, we have some good specialists, you know, we have a urologist here that can also help with anything that um, you know, that I may feel that needs, you know, that specialty care.
SPEAKER_01Okay. And you mentioned this briefly, but if someone isn't your primary care patient, I mean you'll you'll take patients regardless of who they go to for primary care for this service.
SPEAKER_00Yeah, correct. Um, I kind of see it a couple different ways. I do have patients that keep their primary care and I just manage their testosterone replacement therapy, which is perfectly fine. I also get some patients that this is kind of the thing that gets them in the door and they establish care, and then I also become their primary care provider. So I think for young guys that don't typically seek care, this sometimes is a nice pathway to get them in the door. And then we can say, hey, you know, it's a good idea to also do your annual wellness exam, get some other blood work on you.
SPEAKER_01So, ladies listening, if that's a way to get your guy in the door, please do so because we know that men most often delay care until they absolutely need it, until maybe something's worse. Am I am I over exaggerating on that, Travis?
SPEAKER_00No, I think I think that's a it's a fair assessment.
SPEAKER_01And to know, hey, we have some awesome providers here, both male and female here to take care of our population. Travis, if someone wants to schedule, what's the best way to do that? Do they need a referral? I mean, what does that process look like?
SPEAKER_00Yeah, so no referrals necessary. Um, if you just contact our outpatient services and ask for an appointment with me, um they can get you set up. Just let them know what you want to be seen for and we can kind of go from there.
SPEAKER_01And so for any of our patients who are maybe newer to us or maybe they've seen Travis in years past, he is over at our outpatient services center um on the west side of the hospitals. So kind of a little bit different location, but does a lot over there and still able to provide primary care and a variety of uh different services in that area. Anything else we didn't hit on, Travis, that you want want the listeners to know?
SPEAKER_00I don't think so. I think we had a pretty good discussion there.
SPEAKER_01Okay. Well, low testosterone can affect energy, move, overall quality of life. But the good news is that there are evidence based treatments into and trusted local providers who can help. Travis, thank you for helping us break this down important men's health topic, and maybe it'll help get your guys in the door to help um take care of their health. And if you would please like, subscribe, and share this podcast with others who might need to hear it. And until next time, stay well.