Low testosterone

[272BHP]

Funk said:

One of my first questions will be something pointed out in the responses to my results posts here re. the oestradiol levels being 50x higher than testosterone for example. I'd also like to find out if I start treatment with MHC in the next few weeks whether there would be scope to get my GP involved and get (ideally) both prescribed via the NHS sooner rather than later. I did note that the NHS seems to not agree with the HCG element in conjunction with TRT so it's possible they will refuse to cover both for example.

You need to speak to the doctor on consultation about the possibility of shared care in the first instance. To address the other question however and some earlier ones about what is on offer with the NHS.

Usually the NHS do not bother at all with E2 (Oestradiol) and I have never known anyone on a NHS TRT protocol who has been prescribed an aromatase inhibitor. Given that E2 levels are a crucial part of the hormone balance this has always seemed odd to me.

I think I have heard of someone who was prescribed HCG whilst on TRT but this could have been for fertility reasons and they were trying for a baby - I cannot remember.

Usually NHS treatment is Nebido 12 weekly injections, daily Gels.

Sustanon is also commonly prescribed and is usually 250mg every 3 weeks - a protocol pretty much guaranteed to either make you feel great or weird in the first week, ok in the second and pretty grim in the third.

I have heard of people being prescribed Testosterone Enanthate on the NHS but again, this is unusual.

[Funk]

Sounds like pretty much no chance of getting the cypionate on NHS then, along with a few other things to consider - if I want shared care then it'd more likley be dictated by what the NHS would prescribe, negating the benefits of a more tailored/considered approach privately (such as the whole idea of micro-dosing rather than a massive wallop of T at once then nothing for several weeks...).

I will get in touch with my GP about what MHC are proposing and go from there. Thanks for the reply, appreciated.

[Mark Lewis]

lord trumpton said:

With the older demographic ie 50s and above, stopping trt particularly after long term use will be very a difficult and long term wait that may or may not see the return of the body's own t

Plus that period would be one without any t in the body...they will feel absolutely dreadful

I'm on trt and it's great but people need to understand the gravity of their choice and not just the marketing guff that these 'specialist men's wellbeing' clinics that are cropping up and monetising the issue

Definitely possible but everyone’s different. I’m 50 and was able to stop cold turkey (just as an experiment) after a few years use and saw pre TRT levels within 6 weeks. Granted, I didn’t feel tip top! But nice to know it’s a possibility.

[Mark Lewis]

Funk said:

Sounds like pretty much no chance of getting the cypionate on NHS then, along with a few other things to consider - if I want shared care then it'd more likley be dictated by what the NHS would prescribe, negating the benefits of a more tailored/considered approach privately (such as the whole idea of micro-dosing rather than a massive wallop of T at once then nothing for several weeks...).

I will get in touch with my GP about what MHC are proposing and go from there. Thanks for the reply, appreciated.

MHC are quite set in their ways, and beliefs, when it comes to the “perfect” protocol. It is nearly always going to include HCG (Whether you have fertility concerns or not) and subcutaneous injections, microdosed. Their rather fixed approach was a reason I moved over to Leger (and cost - I use sustanon, tri weekly and IM so my total TRT treatment less then my protein powder spend )

Good luck with the NHS. I think I’d be more likely to discuss my hormones with my postman before a GP.

[Legacywr]

Mark Lewis said:

MHC are quite set in their ways, and beliefs, when it comes to the “perfect” protocol. It is nearly always going to include HCG (Whether you have fertility concerns or not) and subcutaneous injections, microdosed. Their rather fixed approach was a reason I moved over to Leger (and cost - I use sustanon, tri weekly and IM so my total TRT treatment less then my protein powder spend )

Good luck with the NHS. I think I’d be more likely to discuss my hormones with my postman before a GP.

Could you explain this in a bit more detail

[Mark Lewis]

Legacywr said:

Could you explain this in a bit more detail

Do you mean my own protocol? If you do - I take no AI, no HCG - just sustanon 250 injected intramuscular three times a week. Monday, Wednesday, Friday. This gives a total injected amount of 120 mg. Ish (I sometimes forget a day and don’t bother to catch up)

Sustanon cost very little. Few pounds a week. Leger clinic is a fixed annual retainer - I forget how much, but not a lot. Another few pound a week I expect and then I do blood test every few months. I use Medichecks for this but keep the cost down by doing the blood draw myself (don’t do that!)

It’s not free, obviously, but The additional productivity I am able to achieve on TRT outweigh any cost.

[lord trumpton]

Mark Lewis said:

Legacywr said:

Could you explain this in a bit more detail

Do you mean my own protocol? If you do - I take no AI, no HCG - just sustanon 250 injected intramuscular three times a week. Monday, Wednesday, Friday. This gives a total injected amount of 120 mg. Ish (I sometimes forget a day and don’t bother to catch up)

Sustanon cost very little. Few pounds a week. Leger clinic is a fixed annual retainer - I forget how much, but not a lot. Another few pound a week I expect and then I do blood test every few months. I use Medichecks for this but keep the cost down by doing the blood draw myself (don’t do that!)

It’s not free, obviously, but The additional productivity I am able to achieve on TRT outweigh any cost.

Have you ever bumped up the dose to see how things respond I terms of performance etc?

[Mark Lewis]

Yes, went up around 180/200 a week. Skin got oily. Pointless (for me)

Mood and mental health, which I’d the only reason I use TRT stayed the same.

[Legacywr]

Mark Lewis said:

Do you mean my own protocol? If you do - I take no AI, no HCG - just sustanon 250 injected intramuscular three times a week. Monday, Wednesday, Friday. This gives a total injected amount of 120 mg. Ish (I sometimes forget a day and don’t bother to catch up)

Sustanon cost very little. Few pounds a week. Leger clinic is a fixed annual retainer - I forget how much, but not a lot. Another few pound a week I expect and then I do blood test every few months. I use Medichecks for this but keep the cost down by doing the blood draw myself (don’t do that!)

It’s not free, obviously, but The additional productivity I am able to achieve on TRT outweigh any cost.

Ah, thanks, I’m not familiar with this product?

[Mark Lewis]

Sustanon? Just another way of packaging test. I’ve used enanthate, cyp and this. Used with a 3 day a week protocol I never noticed any difference between them. Sustanon is designed for staggered release over time but used the way I use it, it makes no difference.

[Legacywr]

Mark Lewis said:

Sustanon? Just another way of packaging test. I’ve used enanthate, cyp and this. Used with a 3 day a week protocol I never noticed any difference between them. Sustanon is designed for staggered release over time but used the way I use it, it makes no difference.

Very interesting, can I ask how old you are, are you taking it due to a deficiency or to enhance what you already have?

How uncomfortable is the fluid transfer?

How much work/cost was involved in getting your first dose from Leger?

[lord trumpton]

Legacywr said:

Mark Lewis said:

Sustanon? Just another way of packaging test. I’ve used enanthate, cyp and this. Used with a 3 day a week protocol I never noticed any difference between them. Sustanon is designed for staggered release over time but used the way I use it, it makes no difference.

Very interesting, can I ask how old you are, are you taking it due to a deficiency or to enhance what you already have?

How uncomfortable is the fluid transfer?

How much work/cost was involved in getting your first dose from Leger?

The NHS have the capacity to prescribe Test Cypionate, Enanthate and Sustanon - just need a endo who will play ball but I know a few who have been successful. That had to try the gel and nibedo first though

[Legacywr]

lord trumpton said:

Legacywr said:

Mark Lewis said:

Sustanon? Just another way of packaging test. I’ve used enanthate, cyp and this. Used with a 3 day a week protocol I never noticed any difference between them. Sustanon is designed for staggered release over time but used the way I use it, it makes no difference.

Very interesting, can I ask how old you are, are you taking it due to a deficiency or to enhance what you already have?

How uncomfortable is the fluid transfer?

How much work/cost was involved in getting your first dose from Leger?

The NHS have the capacity to prescribe Test Cypionate, Enanthate and Sustanon - just need a endo who will play ball but I know a few who have been successful. That had to try the gel and nibedo first though

I failed at my last attempt

[Yazza54]

I think I'm going to try and eat better and do more exercise then come back to this after another test when I've actually attempted to simply look after myself better. My results were sub optimal but not super low. It concerns me that taking any sort of test supplement will make my body produce even less and then that's it for life.

[xx99xx]

Yazza54 said:

I think I'm going to try and eat better and do more exercise then come back to this after another test when I've actually attempted to simply look after myself better. My results were sub optimal but not super low. It concerns me that taking any sort of test supplement will make my body produce even less and then that's it for life.

There are loads of natural supplements out there that claim to increase natural T production. They may work for some people but if you have a physiological problem that is suppressing T production then supplements are unlikely to make any difference.

[simons123]

Yazza54 said:

I think I'm going to try and eat better and do more exercise then come back to this after another test when I've actually attempted to simply look after myself better. My results were sub optimal but not super low. It concerns me that taking any sort of test supplement will make my body produce even less and then that's it for life.

What are your T levels?? Mine is 6nmol but that is due to the mumps I had when I was 20 and no amount of eating better, exercise, etc will boost those levels. If you are sitting above 10 then yes you could potentially boost it naturally but below those levels normal suggest there is an issue.

[Yazza54]

simons123 said:

Yazza54 said:

I think I'm going to try and eat better and do more exercise then come back to this after another test when I've actually attempted to simply look after myself better. My results were sub optimal but not super low. It concerns me that taking any sort of test supplement will make my body produce even less and then that's it for life.

What are your T levels?? Mine is 6nmol but that is due to the mumps I had when I was 20 and no amount of eating better, exercise, etc will boost those levels. If you are sitting above 10 then yes you could potentially boost it naturally but below those levels normal suggest there is an issue.

This is what my basic finger prick test from manual spat out

0.322nmol/l free testosterone (sub optimal)
Testosterone 13.5nmol/l (sub optimal)

I'm only 34 so I'm a bit concerned about fking about with my body any more than I already have by throwing hormones the mix too

[Mark Lewis]

Legacywr said:

Very interesting, can I ask how old you are, are you taking it due to a deficiency or to enhance what you already have?

How uncomfortable is the fluid transfer?

How much work/cost was involved in getting your first dose from Leger?

50

Yes, deficiencies. I would never take test to enhance ok levels.

Fluid transfer???

As easy as getting a pair of glasses. If you have a need, they give them to you.

[Funk]

Spoke to my GP today, managed to get the same guy who's referred me to the endocrinology specialist and who'd mentioned private. I mentioned that I was going to see TMHC and their treatment recommendation was Test Cyp + HCG microdosed subcutaneously. I said if I started treatment with them and found it working well whether I could transfer the prescription started by 'secondary care' to be fulfilled by the NHS and he said that whilst there isn't an option for proper 'shared care' with my local surgery, they would potentially be able to do that for the testosterone only. He pulled up a list of the TRT that could be prescribed which includes testogel, tostran, sustanon, and testosterone undecanoate. He said that testosterone enanate was possible but is 'non-formulary' (I don't know what that means) so they wouldn't use it ideally. I know another poster mentioned that their Trust could prescribe T Cyp, interestingly...

I mentioned that the initial treatment would be 3 months' worth and he said that that should be sufficient for them to take over the T prescription if it's demonstrably working well and I'm showing improvement. It looks like the endocrinology referral with my local NHS trust will be at least 6 months anyway so hopefully the GP will help me shortcut things where it's within his ability to do so ahead of any referral.

He did seem surprised it would be subcutaneous injections that TMHC are recommending. What this has done is help me with considering the questions I have ahead of my appointment with TMHC, I have a several things to ask them now.

Edited by Funk on Thursday 16th May 18:09

[Big Worm 1]

I've recently had a couple of blood tests which have both shown i have low testosterone. My GP referred me to the endocrinology department at my local hospital, but the waiting list is 61 weeks!!
When i asked her for other options, she suggested i go private to get a consultant to look at my results, and determine what my treatment should be, then she will prescribe it under the NHS.