Hormone optimization at Pinnacle Performance & Wellness in Lubbock, Texas is individualized hormone replacement therapy based on comprehensive lab testing and symptoms, supervised by Stuart Riggins, FNP-C. It includes testosterone replacement therapy (TRT) for men and hormone replacement therapy (HRT) for women, with ongoing lab monitoring. Available in person at 8347 Upland Avenue and by telehealth across Texas, Oklahoma, Colorado, Kansas, New Mexico, and Arizona.
Medically reviewed by Stuart Riggins, FNP-C — Pinnacle Performance & Wellness, Lubbock, TX

The Premise
Reference ranges on a lab report describe a statistical distribution of the people who got tested at that lab — not a target for how you should feel or function. A 42-year-old man with a total testosterone of 320 ng/dL sits inside a typical reference range and is often told nothing is wrong, while reporting flat energy, disappearing morning erections, worse recovery from training, and a body composition that has changed despite identical habits.
That gap is the entire premise of this service. Pinnacle evaluates the full panel against your symptoms, your training, your sleep, and your goals — and where treatment is indicated, targets a range where you function well rather than a range you merely fall inside. Equally, treatment is not the answer to every low-normal number. Some patients arrive convinced they need testosterone and leave with a sleep apnea referral, an iron panel, or a thyroid diagnosis, because that is what the labs showed.
TRT For Men
No responsible clinic prescribes testosterone from a symptom questionnaire. Baseline testing at Pinnacle includes total and free testosterone, SHBG, LH and FSH, estradiol (sensitive assay), prolactin where indicated, PSA, CBC with hematocrit, CMP, lipids, HbA1c, and thyroid function. Testosterone is drawn in the morning, and clinically significant results are confirmed on a repeat draw before treatment starts, because a single low value can be produced by illness, poor sleep, or the timing of the blood draw.
Those tests are not bureaucracy. LH and FSH separate primary from secondary hypogonadism, which changes what should be prescribed. SHBG explains why a “normal” total testosterone can leave you with very little free hormone. Hematocrit and PSA set the safety baseline that gets monitored for as long as you are on therapy.
Delivery Methods
| Method | Frequency | Notes |
|---|---|---|
| Injection (cypionate/enanthate) | Weekly or twice weekly, self-administered | Most controllable, most cost-effective, easiest to adjust or stop. The default for most patients here. |
| Cream / gel | Daily, topical | No needles. Requires care around transfer to partners and children; absorption varies. |
| Pellets | Every 3–5 months, in-office insertion | Convenient. Dose cannot be adjusted once inserted, and levels commonly peak high then trough low. |
| Oral (newer formulations) | Daily | Limited use; requires specific monitoring. |
We will tell you which we think fits and why. The pellet market is heavily marketed in West Texas because it is a repeating in-office procedure; that is a business reason, not a clinical one, and for many patients injections give better control at lower cost.
HRT For Women
Perimenopause commonly starts in the early-to-mid 40s and can run for years before periods stop. The symptoms — disrupted sleep, night sweats, new anxiety, brain fog, joint aches, changed body composition, low libido, vaginal dryness, and worsened recovery from training — get attributed to stress, parenting, or age, frequently by a provider who never ordered a hormone panel.
Pinnacle evaluates estradiol, progesterone, FSH, testosterone (yes, women need it too and it is routinely ignored), thyroid, and metabolic markers, then builds a protocol around symptoms and stage. That may include estradiol and progesterone, low-dose testosterone where appropriate, vaginal estrogen, or non-hormonal management. Care is individualized and monitored — not a one-size pellet inserted on a schedule.
The Process
Symptom history, medical history, medications, training, sleep, and goals. In person or by telehealth.
The full panel above, drawn in the morning.
The actual numbers, explained. You will know what your free testosterone, SHBG, estradiol, and hematocrit are and what they mean.
Where treatment is indicated, with dosing, administration training, and what to expect week by week.
The first repeat panel, with dose adjustment based on results and symptoms rather than a fixed script.
Labs at regular intervals for as long as you are on therapy. Hematocrit, PSA, estradiol, and lipids are tracked, not assumed.
Most men report changes in energy and sleep in weeks two to four, libido and mood by week six, and body composition changes over three to six months when training and protein intake support it. Timelines vary.
Common Questions
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West Texas’s integrated human performance and wellness center. Clinical precision. Athletic methodology. One system.
8347 Upland Ave · Lubbock, TX 79424
Office hours:
Monday to Thursday: 8am - 5pm
Friday: 8am to 12pm
Saturday: By appointment
Sunday: Closed
© 2026 Pinnacle Performance & Wellness, LLC · Lubbock, TX
Disclaimer
All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.