I'm Tired Every Afternoon and My Sleep Isn't the Problem. Here's What I Found Before Signing Up.
Straight up: I haven't had a testosterone prescription from anyone. This page is what I checked before deciding to get my labs done through Keeps, written down so you don't have to do it twice. I'll add dated updates as I go. VitalityVerdict earns a commission if you sign up through the paid links here. It doesn't change what's below, including the parts Keeps wouldn't put on its own site.
Written by Galen Schneider. I have not used Keeps TRT and have not been prescribed testosterone. This is what I found researching it before starting, and I'll update this page with dates once I do. VitalityVerdict earns a commission if you sign up for Keeps through the paid links on this page.
The verdict up front
Keeps TRT is a real telehealth testosterone program: labs first at Quest or Labcorp, a licensed clinician, a needle-free oral option, and a $49 entry that gets you the blood panel and consult. That's why I'm doing my labs there and not somewhere else. It's also newer than the hair-loss side of Keeps, runs on a white-label platform, prescribes compounded medication that isn't FDA-approved, and has a handful of billing complaints already.
Before you pay the $49, know these four things:
- $49 is the entry, not the price. After a prescription it's a membership fee billed every 84 days plus a medication fee every 12 weeks - marketed as about $159 a month for injections and $199 for the oral tablet. Screenshot your checkout; brand materials show two different sets of numbers.
- Your clinician may be a nurse practitioner or physician assistant, not an MD. That's in the telehealth consent.
- The medication is compounded. Keeps' own footer says it "has not been reviewed or approved by the FDA."
- Nobody promises you a prescription. If they say no, you get the $49 back.
Why I'm here
I'm 36, I have two kids, and my day looks like this. Up with the kids, school and daycare drop-off, work, a workout somewhere in the late morning. Lunch. Then, like clockwork, 1pm to 3pm disappears. I'm not sleepy exactly - I'm drained. Flat. I try a short nap. I drink coffee. Neither does much. Around 3pm I get a second wind that gets me through the afternoon, but "a bit tired" is my baseline for the rest of the day.
Here's the part that made me stop blaming the obvious thing. I noticed this pattern after my first kid started sleeping through the night. I was finally getting full nights too - and I still felt like this. So I went hard on sleep. Consistent schedule, dark room, the works. My sleep trackers put me at 88 to 99 out of 100 almost every night. No snoring, no disorder, no waking up at 3am. Sleep is the one thing in my life I've actually optimized.
Then I did the rest of the checklist. I stopped drinking. I work out more than I ever have. I eat better than I did in my twenties. Three years of hitting the gym hard and I've gained a few pounds of muscle and kept roughly the same body fat. That's a disappointing return on three years.
My brother is on TRT and has had a great experience. I went through a low-T symptom checklist and ticked most of it. I've never had my testosterone tested. That's the actual state of things: a strong hunch, one family data point, zero numbers.
I'm getting the numbers through Keeps. Here's what I found out about them first.
What Keeps TRT actually is - and who's behind it
This is the section I couldn't find anywhere else, so it's the reason to read this page even if you skip the rest.
Keeps is owned by Thirty Madison, Inc. (Keeps, Nurx, Cove), which agreed in September 2025 to be acquired by Remedy Meds, a GLP-1 weight-loss telehealth company. The TRT program lives at trt.keeps.com, and the terms of service are with "Thirty Madison, Inc. d/b/a Keeps." Clinical care is delivered by KMG Medical Group, with OpenLoop Healthcare Partners and JMP Medical also named as the medical entities.
Under the hood, though, trt.keeps.com is a white-label version of another TRT platform. The page code uses product SKUs named "titan-trt-...", the support phone number (551-209-3340) is the same one listed by jointitan.com, and a May 2026 promotional article describes Keeps TRT as operated by Titan Meds Platform LLC. Whether Titan is a Remedy Meds subsidiary I couldn't confirm.
Does that make it illegitimate? No. Real medical group, real labs, real pharmacy, real terms of service. It does mean the "Keeps" name is carrying trust earned on hair loss since 2018 into a testosterone program that's about a year old and built by someone else. I'd rather know that than not.
Is Keeps TRT legit? The checklist
| What I checked | What I found |
|---|---|
| Labs before prescription? | Yes. A blood panel at Quest, Labcorp or BioReference (walk-in with the lab order, no appointment). At-home kit only if there's no partner lab within 50 miles. |
| What's on the panel | "12+ biomarkers." The platform's member guide lists free testosterone, FSH, LH, estradiol, AST, ALT, prolactin, PSA, hematocrit, SHBG and albumin. Labs are also required before every refill or dose change. |
| Who prescribes | Licensed clinicians through KMG Medical Group. The consent form says it may be an NP or PA. |
| Will they consider me at "normal" levels? | Their FAQ literally asks "My testosterone level is 350, which is considered normal... am I a candidate?" and says they look at symptoms, not just numbers. The terms say no prescription is guaranteed. |
| States | The platform serves 50 states plus DC, but "TRT may not be available in every state." Check before paying. |
| Insurance | No. Cash-pay. HSA/FSA accepted. |
| Compounded? | Yes. Footer: "Medications prescribed through Keeps affiliated clinicians have not been reviewed or approved by the FDA for quality, safety, or effectiveness. Testosterone replacement therapy (TRT) may impair fertility." |
| Reputation | keeps.com is 3.5 on Trustpilot (277 reviews, mostly hair loss). TRT-specific complaints from spring 2026 are about billing, not care. Details below. |
What it costs (verified Sept 21, 2026)
Getting in: $49, "reduced from $149," covers the lab panel, the clinician consult and a treatment plan. Keeps says you can start "in as little as 5 days." If the clinician decides you're not a candidate, you get 100% of the $49 back.
Staying in: two separate charges. A Program Membership Fee billed every 84 days (covers labs, consults and prescription management), and a Medication Fee charged when the first script is written and then every 12 weeks. The marketed monthly equivalents:
| Format | Marketed price | What it is |
|---|---|---|
| Testosterone cypionate injection | ~$159/month | Subcutaneous, weekly or every two weeks, small insulin-style needle |
| Testosterone ODT (oral dissolving tablet) | ~$199/month | Dissolves against the gum, once or twice daily. No needle. |
| Enclomiphene ODT | ~$199/month | Not testosterone. Signals your body to make more of its own. Preserves fertility. Off-label. |
Two warnings. First, I found brand materials quoting $159/$199/$199 and others quoting $200/$200/$250 for the same three tiers. A Trustpilot reviewer in June 2026 said "200 a month." Screenshot your checkout. Second, the first shipment is an 8-week supply and renewals are 12-week, so your first medication charge covers two months at once - one reviewer was surprised by that.
My first-90-days math for the oral tablet (my pick - see below): $49 to start, then a membership fee plus roughly $199 x 2 months for the first shipment, then the 12-week cycle. Call it somewhere north of $450 before I know if it's working - the membership fee isn't published as a standalone number, so I'll confirm it at checkout and put the real figure in the Updates section below. Against that, Keeps' hair-loss business taught me they'll tell you the real number if you make them - so I'll be making them.
Refunds: the membership fee is non-refundable once paid. The medication fee is non-refundable once the pharmacy starts filling. The one real safety net is the guarantee below.
The Higher-T guarantee, with all the conditions
Keeps says that if your total testosterone hasn't risen at least 20% after 90 consecutive days on treatment, they refund your most recent cycle's membership and medication fees. The conditions, in full: 90 consecutive days on the plan as prescribed; follow-up labs to show the number; one refund per customer, ever; you have to email [email protected] within 30 days of the qualifying labs. It refunds the last cycle, not everything you've paid.
That's a real guarantee. It's also a guarantee about a lab number, not about how you feel at 2pm. Read it that way.
Why I'm choosing the oral tablet
I very much dislike needles. That's most of it. Injections are the cheapest tier at Keeps and at every other clinic, and I'm going to pay about $40 a month more to not do them.
Enclomiphene is the fertility-preserving route and a lot of guys in their thirties should look at it first. My wife and I are done having kids, so fertility isn't a factor for me, and I'd rather take the direct route. If you're not done, ask the clinician about enclomiphene before anything else - testosterone therapy can shut down sperm production within a couple of months, and while most men recover after stopping, "most" isn't "all."
Before I blame testosterone
I want this section here because the guy searching "keeps trt review" at 2:30pm is me, and the honest thing I can tell him is: get the number, and get a few other numbers with it.
Sleep is my strongest alibi - I have three years of tracker data saying it's not sleep. Alcohol is out. Training and diet are dialed. So what's left that mimics low T? Thyroid (a TSH test), iron and ferritin, vitamin D and B12, blood sugar (A1c), depression, and any medications you're on. Keeps' panel doesn't include TSH or ferritin. I'm asking my regular doctor for those the same week I do the Keeps draw, and I'd suggest you do the same. If my T comes back at 650 and my ferritin is on the floor, I want to know that before I'm on a hormone for life.
And my brother's great experience is my brother's. It's why I'm curious. It's not evidence about my body.
The fears, with numbers
- Can I stop? Yes. Your natural production is suppressed while you're on it and generally recovers after, sometimes with a taper; it can take months. This is the "once you start" worry and it's legitimate - it's a long-term commitment, not a supplement.
- Fertility. Testosterone therapy suppresses sperm production, often to near zero within about 10 weeks. Roughly two-thirds of men recover within 6 months of stopping and about 90% by 12 months. Enclomiphene avoids this. Doesn't apply to me; might to you.
- Testicles. They shrink on TRT - one study measured about a 17% volume loss over two years. Nobody puts that on a landing page. I'm putting it here.
- Heart. The big TRAVERSE trial (about 5,200 men, ages 45 to 80, published 2023) found no increase in major cardiac events but did find more atrial fibrillation (3.5% vs 2.4%), pulmonary embolism (0.9% vs 0.5%) and kidney injury. In 2025 the FDA dropped the boxed heart warning on testosterone products and added a blood-pressure warning. Your hematocrit and blood pressure need watching. Keeps' panel includes hematocrit; make sure someone's looking at it.
- Hair. Yes, higher testosterone can accelerate male-pattern hair loss in men who are prone to it. I'm on finasteride already (that's a whole other page). If you're not, this is a real conversation to have with the clinician.
What the Trustpilot complaints actually say - and what I'll do about them
The TRT-specific one-star reviews from April to June 2026 aren't about the medicine. They're about money and communication:
- "keeps charged me the 200 without my approval" (June 2026)
- a man who says the clinician "would not tell me the price" before he was billed almost $400 (May 2026)
- a dose that "overshot" and was then discontinued rather than adjusted, ending with "find somewhere local" (May 2026)
- surprise that the first shipment is two months charged as one (April 2026)
Every one of those is avoidable if you know it's coming. So: I'm not accepting a prescription until I've seen the plan and the price in writing. I'm screenshotting the checkout. I'm putting the 84-day renewal in my calendar with a week's warning. And if the first dose is wrong, I'm asking for an adjustment before I ask for anything else.
Keeps TRT vs Hone vs Fountain vs my doctor
| Keeps TRT | Hone Health | Fountain TRT | Urologist + insurance | |
|---|---|---|---|---|
| Entry | $49 labs + consult | ~$65 biomarker test (list $165) | Labs included | Copay; usually two morning draws under 300 ng/dL before insurance pays |
| Ongoing | ~$159 inj / ~$199 oral, 84-day membership + 12-week meds | ~$135/mo membership + meds (~$165-$200 all-in) | $199 per 28 days, labs included | Generic cypionate ~$35/vial + visits |
| Needle-free option | Yes - oral ODT, enclomiphene | Cream, troches, enclomiphene | Cream, enclomiphene | Depends on the doctor |
| Borderline levels | Considers symptoms with "normal" labs | Reported to send borderline men to 3 months of lifestyle first | Symptoms + labs | Usually no below 300 |
| Guarantee | 20% T rise in 90 days or last cycle refunded | $135 refund if not a candidate | None found | n/a |
Hone is the more established name and stricter about who it treats. Fountain's all-in price is simple. My doctor would be the cheapest if I qualified on paper, and I probably wouldn't. I'm choosing Keeps because it's the brand I already know from the hair-loss side, the $49 entry is the lowest-risk way to get real labs, they have the oral option, and their model is built around ongoing follow-up rather than a one-time script. I'll find out whether the model holds up and report back.
What happens after you pay $49
- Health questionnaire online.
- Lab order sent to you; walk into Quest, Labcorp or BioReference, no appointment.
- Results back to a KMG clinician; video consult.
- If prescribed: first 8-week shipment, free discreet shipping, about 2 business days to process and 3 to 5 in transit.
- Renewal form opens 28 days after the prescription; labs before every refill or dose change.
- Support: [email protected] or 551-209-3340, 8am to 8pm Eastern, seven days.
Who Keeps TRT is not for
- You want more kids and haven't talked to anyone about it. Ask about enclomiphene first.
- You want insurance to pay. It won't.
- You want an MD specifically. You may get an NP or PA.
- Your state is excluded. Check before paying.
- You haven't ruled out sleep. I have; most guys haven't. If you snore or wake up unrefreshed, get that looked at first - untreated sleep apnea plus testosterone is a bad combination.
FAQ
Is Keeps TRT legit?
Yes: labs at Quest or Labcorp before any prescription, licensed clinicians through KMG Medical Group, a written terms of service and a refund if you don't qualify. It's a white-label program (Titan platform) under the Keeps brand, about a year old, prescribing compounded medication. Legit and new aren't the same thing; it's both.
How much does Keeps TRT cost?
$49 for labs and consult. Then roughly $159 a month for injections or $199 for the oral tablet or enclomiphene, billed as an 84-day membership fee plus a 12-week medication fee. Verified Sept 21, 2026; brand materials conflict, so screenshot your checkout.
Does Keeps prescribe if my testosterone is "normal"?
Their FAQ says they consider symptoms alongside a level like 350, which many doctors call normal. No prescription is guaranteed and a clinician decides. Testosterone is a Schedule III controlled substance.
Does Keeps TRT require injections?
No. There's an oral dissolving tablet and enclomiphene. Injections are the cheapest tier.
Is the medication FDA-approved?
No. Keeps' TRT medications are compounded and its site states they have not been reviewed or approved by the FDA.
Can I cancel Keeps TRT?
Yes, anytime before the next billing date. Membership fees already paid aren't refunded, and medication fees aren't refunded once the pharmacy starts filling.
My verdict, for now
I'm getting my labs through Keeps because it's the cheapest honest way to get a real number from a real lab with a clinician attached, and because if the number says what I think it says, the needle-free path is right there. I'm walking in with my eyes open about the price structure, the compounded meds and the billing complaints, and I'm getting TSH and ferritin from my own doctor the same week.
I'll update this page with what happens - labs, the yes or no, and how a Tuesday afternoon feels at 30, 60 and 90 days. Until then, this is research, not a testimonial. I haven't used Keeps TRT.
Updates
[Dated entries go here as they happen. Never backfilled.]