True North Metabolic
FAQ
Frequently Asked Questions
We offer two separate service lines: Weight Loss & Metabolic Health and Men’s Health.
Still need help? Call (226) 686-0119 or visit the Appointments page to book online.
For Patients
1) Do I need a referral?
Answer: No. A referral isn’t required, but it’s helpful because it lets us coordinate your history, labs, and consult notes with your clinician. You can also self-refer.
2) I don’t have a family doctor—how do I get in?
Answer: You can book directly with us online.
3) Do you prescribe GLP-1 medications (Semaglutide/Ozempic, Wegovy) or Tirzepatide (Mounjaro/Zepbound)?
Answer: Yes, when clinically appropriate after a physician assessment, informed consent, and safety screening. When it is appropriate, we do prescribe this during the first visit.
4) Am I a candidate for medication-assisted weight loss?
Answer: You certainly can be. We consider medical history, BMI, metabolic risks such as prediabetes and fatty liver, prior attempts, and contraindications, then decide together.
5) What does a weight-loss plan look like?
Answer: A physician-led plan that integrates realistic nutrition and activity plans along with medications if indicated, tailored to your biology and schedule.
6) Is True North Metabolic only for men?
Answer: No. We provide two service lines: Weight Loss and Metabolic Health for all adults (women and men) and pediatric weight concerns, and Men’s Health for male-specific issues such as low testosterone. If you are a woman seeking weight management, this clinic is for you.
7) I’m a woman—can I be seen for weight loss (PCOS, postpartum, perimenopause)?
Answer: Yes. We care for women and men. We frequently see women with PCOS-related weight concerns, postpartum changes, and perimenopausal weight gain. We individualize your plan and coordinate with your primary care or OB-GYN as needed.
8) How are Men’s Health and Weight Loss services organized?
Answer: They are two pathways under one clinic. The Weight Loss and Metabolic pathway (for everyone) provides comprehensive assessment, a lifestyle plan, and medication options such as GLP-1s when appropriate. The Men’s Health pathway (male-specific) includes evaluation of symptoms, confirmatory labs, and guideline-based TRT only when indicated, plus follow-up.
9) Do you prescribe testosterone (TRT)?
Answer: Yes, only for patients with laboratory-confirmed low testosterone and when benefits outweigh risks. We also evaluate for reversible causes before treatment.
10) What tests do you do before TRT?
Answer: Typically morning total testosterone with free testosterone, LH and FSH, SHBG, prolactin, CBC, liver enzymes, lipids, ferritin, estradiol, and other tests as clinically indicated. Not every patient requires the same tests.
11) Do you help with recovery after anabolic steroid or PED use?
Answer: Yes. We provide structured assessment, safety labs, and recovery planning. We do not provide advice on performance enhancing substances. We strictly perform health-based assessments and implement preventative care.
12) Do you treat hair loss?
Answer: Yes. Our clinic in Kitchener treats hair loss. We assess likely causes and discuss evidence-based options. We do prescribe medications such as finasteride when appropriate and when you wish to begin treatment. In addition, we offer dutasteride mesotherapy.
13) Do you see pediatric patients for weight concerns?
Answer: Yes. Physician-monitored pediatric weight management is available with age-appropriate plans and close follow-up.
14) Are visits covered by OHIP?
Answer: Yes. Physician visits are OHIP-covered as we are providing a medically necessary level of care. Only non-insured items, such as certain forms, may have a fee. If you do not have OHIP, contact us to review options. Other premium private plans are also available. Body Composition Testing is not covered by OHIP.
15) Can I be a patient if I live outside Kitchener-Waterloo, Cambridge, or Guelph?
Answer: Yes. Patients from anywhere in Ontario can attend an initial intake. Follow-ups can be virtual when appropriate. We frequently see patients from over 8 hours away.
16) Where are you located?
Answer: 702 King St W, Kitchener, ON N2G 1E2. We are located inside Midtown Medical Center. Phone (226) 686-0119. Fax (226) 686-0184.
17) How do I get started?
Answer: Use the Appointments page for self-referral or ask your clinician to fax a referral. We will contact you with next steps.
18) How soon could medications start?
Answer: After your assessment and any required labs, we review eligibility and safety, then decide the timeline together. For many patients, this could be the first visit if all requirements are in place.
19) Can I combine weight-loss and men’s health in one plan?
Answer: Often yes. Many patients benefit from an integrated plan addressing body composition, metabolic health, and hormone-related issues.
20) What if I am already on Ozempic or TRT from another clinic?
Answer: We will verify your history, doses, and labs, assess safety, and discuss whether to continue, adjust, or change therapy. In most cases, we will continue and make small adjustments to achieve your goals. Please note that we do need to see evidence of low testosterone in the past in order to continue TRT.
21) Do you coordinate with my family doctor?
Answer: Yes. Consult notes are shared, and we encourage ongoing co-management. If you’ve been referred by another specialist, we also coordinate with them.
22) Do you do virtual appointments?
Answer: Yes. Virtual or phone follow-ups are available when clinically appropriate. The initial intake is in person.
23) What services beyond weight loss and TRT do you offer?
Answer: Preventative health, performance optimization, and targeted screening. All care is physician-led and evidence-based.
24) Do you prescribe finasteride for hair loss / male pattern baldness?
Answer: Yes our Kitchener-Waterloo hair loss clinic does prescribe finasteride and/or dutasteride for hair loss
25) Do you prescribe topical finasteride or topical dutasteride?
Answer: Yes. Our Kitchener-Waterloo based hair loss clinic does prescribe topical finasteride and/or dutasteride.
26) Do you prescribe oral minoxidil for hair loss?
Answer: We do prescribe oral minoxidil for hair loss in our Kitchener-Waterloo hair loss clinic. However only after an extensive risk and benefit discussion as there are risks associated with oral minoxidil for hair loss.
27) Do you prescribe peptides?
Answer: We only prescribe medications approved by Health Canada and practice within guidelines. If a medication is not approved by Health Canada for human use, then we do not ever prescribe it.
26) Do you prescribe testosterone for younger men?
Answer: There is no specific age cut off but we do not routinely start younger men on testosterone unless there is a specific indication and/or diagnosis that warrants being on supplemental testosterone without any alternatives. We recognize the major risk of fertility that is posed by exogenous testosterone.
27) Do you prescribe aromatase inhibitors like letrozole?
Answer: We do not routinely prescribe aromatase inhibitors.
28) Do you prescribe HCG?
Answer: We would primarily prescribe HCG for fertility reasons and not as a routine part of a TRT protocol. In certain pituitary illness mediated hypogonadism cases, we may use HCG.
29) Do you prescribe Clomid / Clomiphene?
Answer: We prescribe Clomiphene only for specific reasons and not as part of a routine TRT protocol.
30) Do you provide advice on anabolic steroids?
Answer: No. We only provide health monitoring advice and interventions, and emphasize harm reduction.
31) Do you prescribe Enclomiphene?
Answer: We do not prescribe Enclomiphene as it is not Health Canada approved.
32) Do you prescribe Pregnenolone?
Answer: We do not prescribe pregnenolone as part of a routine TRT protocol as there is no evidence supporting its use.
33) Do you prescribe DHEA?
Answer: We do not prescribe DHEA.
34) If I am started on TRT, how often do I get blood tests done?
Answer: It depends on the patient. We typically do blood tests within 5-7 weeks after starting. If there are no concerns, we may space it out to 3 months. However, every patient is different.
35) Who is TRT recommended for?
Answer: TRT is recommended for men with low testosterone who are experiencing symptoms who have a good understanding of the risks and benefits.
36) Do you prescribe testosterone for women?
Answer: Currently that is outside of our scope of practice.
37) Does TRT cause prostate cancer?
Answer: The cumulative body of clinical evidence in the 21st century has shown that testosterone therapy does not cause prostate cancer. However, monitoring of the PSA is still important in case of a patient developing androgen sensitive prostate cancer for reasons unrelated to testosterone therapy.
38) Does TRT cause heart attacks and strokes?
Answer: The latest evidence, such as the TRAVERSE trial, has shown that testosterone replacement therapy does not appear to be a direct risk factor for heart attacks and strokes. However, TRT may upregulate certain risk factors for heart disease such as hypertension. That is why a proper TRT protocol and close monitoring is essential to ensure it is done in a healthy manner.
For Physicians
How do I refer a patient?
Answer: Fax (226) 686-0184. No specific form is required. Please include demographics, reason for referral, medications, relevant labs, and your contact details.
Which patients are appropriate to refer?
Answer: Medical weight management with or without medications; metabolic risk such as fatty liver, prediabetes, or dyslipidemia; suspected or confirmed low testosterone; patients who previously used or actively use anabolic steroids; hair loss in men; and complex lifestyle optimization. We also take referrals for just fatty liver follow-up and management. Please note that we do not routinely start younger men on testosterone therapy.
OHIP billing vs private fees
Answer: Physician visits are OHIP-insured. Only non-insured services, such as some forms, may carry a private fee. Body composition scans are 75$ for the initial scan and 49% for follow up scans.
Can you see patients from outside Kitchener-Waterloo, Cambridge, or Guelph?
Answer: Yes. Patients can attend an in-person intake and be followed virtually when appropriate. This is available Ontario-wide. We frequently see patients from over 8 hours away.
Who will see my patient? What qualifications do they have?
Answer: Patients are seen by Dr. Khashayar Farzam (CCFP, DABFM, ABOM Diplomate), an Emergency Medicine physician at Grand River and St. Mary’s, board-certified in Family Medicine by CFPC and ABFM, and a Diplomate of the American Board of Obesity Medicine. Also a clinical preceptor and university faculty (Adjunct Clinical Assistant Professor, McMaster), an award-winning author, and an international powerlifting competitor and personal trainer/coach with applied strength and conditioning experience.