Low testosterone

[Funk]

Legacywr said:

Funk said:

GP called back, is arranging a referral to endocrine specialist - says it'll be months and if I have the option of private it'd be the time to take it. I like that TMHC will work with my GP/specialist down the line so am getting the ball rolling with them. GP is going to email me an export of my recent results in a usable format that I can share with TMHC.

Don’t be surprised if they want their on blood tests done.

Good point, have already checked that; apparently they're happy as the test results I have are so recent and comprehensive.

[Mezger]

Just had my bloodwork done also, as was curious on T level.
Context, I keep relatively fit, Crossfit around 4x per week, have been been feeling a bit low energy..

Results came back as

FSH Male - 6.6 iU/L
ICSH 4.25 IU/L
Estradiol 91.0 pmol/l
Testosterone 12.77 nmol/L 368ng/dL
Prolactin 57.3 MIU/L 2.69ng/mL

Given a relatively healthy lifestyle, seems a little low, my sleep is far from perfect, but not sure if improving that would get me towards the higher end of the range?

[pidsy]

Anyone done a breakdown of costs from different clinics?

Can start the ball rolling with Optimale.

Cypionate and general clinic costs are £95 pm
HCG £37 a vial every 6 ish weeks (cheaper for 3)
6monthly bloods £70 (plus finding somewhere to get it done). I use Superdrug and it’s £35

Leger and MHC are likely similar but I’d be curious to know.

[The Rotrex Kid]

272BHP said:

Pay for a venous Medichecks test. They have a 20% off Spring sale at the moment. A total testosterone level on its own is not the full picture so this will give a broader view hormone wise.

https://www.medichecks.com/products/male-hormone-c...

If nothing else it gives you a baseline for the future so is well worth the investment.

Thanks for this. Had my appointment yesterday with blood taken and test sent off.

My boss has been on TRT for a few months and says he feels so much better, I’ve been feeling a lot more ‘meh’ for the last few years so we’ll see what happens!

[Yazza54]

I did the initial test, now it's saying I need to do the more accurate enhanced test before they will progress to treatment. Seems like money for old rope, should be done the enhanced test off the bat. This was with manual.

Anyway it gave these results

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

The other two were albumin which was high and SHBG which was just borderline in optimal range.

What treatments have people used and found least intrusive? I was hoping it would be some sort of oral medication but I read some stuff about gels last night which sounds like a pain in the arse doing everyday

[xx99xx]

Yazza54 said:

I did the initial test, now it's saying I need to do the more accurate enhanced test before they will progress to treatment. Seems like money for old rope, should be done the enhanced test off the bat. This was with manual.

Anyway it gave these results

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

The other two were albumin which was high and SHBG which was just borderline in optimal range.

What treatments have people used and found least intrusive? I was hoping it would be some sort of oral medication but I read some stuff about gels last night which sounds like a pain in the arse doing everyday

Gel is probably the least intrusive. It's DIY and takes about 30 seconds to apply and then a minute to dry. I do it whilst sat on the toilet - multi tasking if you like! It's no more a pain in the ass doing it daily as using a moisturiser on your face, brushing your teeth etc every day. It becomes routine.

Injections can be a faff for some if you have to attend a surgery to get it done every 2-3 months. DIY is not an option for some e.g. I physically can't stick a needle in myself (but have no problem with a nurse doing it).

[Yazza54]

xx99xx said:

Yazza54 said:

I did the initial test, now it's saying I need to do the more accurate enhanced test before they will progress to treatment. Seems like money for old rope, should be done the enhanced test off the bat. This was with manual.

Anyway it gave these results

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

The other two were albumin which was high and SHBG which was just borderline in optimal range.

What treatments have people used and found least intrusive? I was hoping it would be some sort of oral medication but I read some stuff about gels last night which sounds like a pain in the arse doing everyday

Gel is probably the least intrusive. It's DIY and takes about 30 seconds to apply and then a minute to dry. I do it whilst sat on the toilet - multi tasking if you like! It's no more a pain in the ass doing it daily as using a moisturiser on your face, brushing your teeth etc every day. It becomes routine.

Injections can be a faff for some if you have to attend a surgery to get it done every 2-3 months. DIY is not an option for some e.g. I physically can't stick a needle in myself (but have no problem with a nurse doing it).

I'm with you on that I struggled enough with the finger prick

When you put it like that gel sounds like a good shout.

I do wonder if I just got back to eating better and exercising more my T levels may come up a bit naturally but it's like a vicious circle as I have no energy or oomph to get started.

[xx99xx]

Yazza54 said:

I'm with you on that I struggled enough with the finger prick

When you put it like that gel sounds like a good shout.

I do wonder if I just got back to eating better and exercising more my T levels may come up a bit naturally but it's like a vicious circle as I have no energy or oomph to get started.

I know what you mean with the vicious circle. I used to drive to the gym and then sit in the car for 15 minutes before driving off again. My aching legs just couldn't drag my ass out of the car to do something I didn't particularly enjoy. I'd feel like I'd run a marathon before even doing any exercise. Gym isn't for everyone!

Maybe try diet first to lose some weight without exercising. And/or start slow with the exercising, like a 10 minute walk every day, then gradually go a bit longer. Even that is better than nothing.

[The Rotrex Kid]

My results came back and I was quite surprised with how ‘good’ they were.

Low DHEA but the doctors notes said that wasn’t a concern.

Testosterone is 20.8 and free testosterone 0.35.

It has spurred me to take a bit better care of myself and lose some weight and I think that might be the cause of my recent ‘meh’ feelings!

[Yazza54]

xx99xx said:

Yazza54 said:

I'm with you on that I struggled enough with the finger prick

When you put it like that gel sounds like a good shout.

I do wonder if I just got back to eating better and exercising more my T levels may come up a bit naturally but it's like a vicious circle as I have no energy or oomph to get started.

I know what you mean with the vicious circle. I used to drive to the gym and then sit in the car for 15 minutes before driving off again. My aching legs just couldn't drag my ass out of the car to do something I didn't particularly enjoy. I'd feel like I'd run a marathon before even doing any exercise. Gym isn't for everyone!

Maybe try diet first to lose some weight without exercising. And/or start slow with the exercising, like a 10 minute walk every day, then gradually go a bit longer. Even that is better than nothing.

Oh I do plenty of walking, but when it comes to properly exerting myself particularly for purely aesthetic reasons like going to the gym I literally just get there and have nothing to give. I think half my problem is there has to be some sort of competitive element to what I'm doing or I'm just not interested.

[simons123]

The Rotrex Kid said:

My results came back and I was quite surprised with how ‘good’ they were.

Low DHEA but the doctors notes said that wasn’t a concern.

Testosterone is 20.8 and free testosterone 0.35.

It has spurred me to take a bit better care of myself and lose some weight and I think that might be the cause of my recent ‘meh’ feelings!

Yeah you definitely don't need TRT with those numbers. 20.8 is really good. Sounds like you just need to hit the gym.

[simons123]

3 weeks since I've had my first Nebido injection.

Heard it's a really painful injection due to how thick the oil is, but for me it never hurt in the slightest.

Zero negative side effects so far and most importantly no hair loss thus far.....in terms of positive then I'd say my brain fog has lifted massively. Other then that feel no different.

I have another injection in 3 weeks time and then it's every 12 weeks. Have a 12 month review with the doctor where I'm going to push for the injection to be administered every 10 weeks.

How often do you guys have blood tests to see how your TRT injections are working? Do you just ask the nurse??

[lord trumpton]

Just something to remember for the folk considering trt in later years....Once you're on itits a lifetime commitment

Your balls will likely stop producing the depleted testosterone they are currently making and you will be dependent on what you administer.

Hcg can help but its nit without its own issues like elevated E2 levels

[Mark Lewis]

lord trumpton said:

Just something to remember for the folk considering trt in later years....Once you're on itits a lifetime commitment

Your balls will likely stop producing the depleted testosterone they are currently making and you will be dependent on what you administer.

Hcg can help but its nit without its own issues like elevated E2 levels

That’s not necessarily the case, although certainly a possibility. For others, stopping TRT will see levels return to pre TRT numbers. Although, the reason for stopping would need to be pretty good - be a bit like stopping wearing your glasses …. If they help you see better, keep them on till you’re dead

[lord trumpton]

Mark Lewis said:

That’s not necessarily the case, although certainly a possibility. For others, stopping TRT will see levels return to pre TRT numbers. Although, the reason for stopping would need to be pretty good - be a bit like stopping wearing your glasses …. If they help you see better, keep them on till you’re dead

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

[FNG]

FWIW I was on fortnightly injections to begin with, moved to gels, tried 2 different ones and ended up around the 17-20 mark which did seem to help matters - that said I ended up stopping the whole lot as it felt like the benefit was dropping off - it was making very little difference mentally, but was just emphasising the lack of physical relationship with my wife (who has had zero sex drive since having kids and can't see that changing now).

Been off it for over a year and my annual appointment came around again. Got tested a couple of months ago, T around the 6.0 mark and the endo basically left it up to me whether I wanted to restart or not. I talked it around with the endo for a while and thought about it myself for a while too, then decided to restart, about 10 days ago.

Can't deny I feel a bit better for being on it again, still can't stop eating crap and I can't seem to get my arse onto my exercise bike either, but monitoring it to see whether the mental effect wears off in time as it appeared to do last time round. Should get next bloods in a few weeks to see where I'm at, adjust the dose accordingly, but am wondering whether I'm going to end up increasing the gel dosage in order to maintain the same level of benefit / gain / what have you.

Incidentally after a very crap start with one of the endos in my local hospital, I got a really decent one who listens to symptoms and isn't just driven by the numbers (although still refers to the NHS guidelines of 15 is target, 5 (I think) is low enough to warrant intervention). In that regard, going by comments on here I've won the NHS postcode lottery, so feeling grateful for that. Warwick hospital, if anyone else is in the same boat and feels like they could do with treatment but can't afford private and don't see the point in going NHS.

[simons123]

FNG said:

FWIW I was on fortnightly injections to begin with, moved to gels, tried 2 different ones and ended up around the 17-20 mark which did seem to help matters - that said I ended up stopping the whole lot as it felt like the benefit was dropping off - it was making very little difference mentally, but was just emphasising the lack of physical relationship with my wife (who has had zero sex drive since having kids and can't see that changing now).

Been off it for over a year and my annual appointment came around again. Got tested a couple of months ago, T around the 6.0 mark and the endo basically left it up to me whether I wanted to restart or not. I talked it around with the endo for a while and thought about it myself for a while too, then decided to restart, about 10 days ago.

Can't deny I feel a bit better for being on it again, still can't stop eating crap and I can't seem to get my arse onto my exercise bike either, but monitoring it to see whether the mental effect wears off in time as it appeared to do last time round. Should get next bloods in a few weeks to see where I'm at, adjust the dose accordingly, but am wondering whether I'm going to end up increasing the gel dosage in order to maintain the same level of benefit / gain / what have you.

Incidentally after a very crap start with one of the endos in my local hospital, I got a really decent one who listens to symptoms and isn't just driven by the numbers (although still refers to the NHS guidelines of 15 is target, 5 (I think) is low enough to warrant intervention). In that regard, going by comments on here I've won the NHS postcode lottery, so feeling grateful for that. Warwick hospital, if anyone else is in the same boat and feels like they could do with treatment but can't afford private and don't see the point in going NHS.

I thought you could own get Nebido or Gels from the NHS....which injections did you get from the NHS which allowed you to have it fortnightly? Sustanon??...

Personally don't like the idea of the gels, just seems a complete ballache to have to do it daily and wait for it to soak in. I went to Derby Hospital and tbf the Endo there was very receptive for every thing I requested such as reviewing my Nebido after the first 12 months to reduce from 12 week injections to 10 weeks then possibly 8....if you can get TRT on the NHS, sod paying £50+ per month for TRT for the rest of my life by going private.

[RSTurboPaul]

If TRT is a 'no going back' option, what options are there for increasing testosterone naturally?

Weight training / Gym?
Losing weight?
Smoking? (if Andrew Tate is to be believed? lol)
Chainsaw juggling?

[FNG]

simons123 said:

I thought you could own get Nebido or Gels from the NHS....which injections did you get from the NHS which allowed you to have it fortnightly? Sustanon??...

Personally don't like the idea of the gels, just seems a complete ballache to have to do it daily and wait for it to soak in. I went to Derby Hospital and tbf the Endo there was very receptive for every thing I requested such as reviewing my Nebido after the first 12 months to reduce from 12 week injections to 10 weeks then possibly 8....if you can get TRT on the NHS, sod paying £50+ per month for TRT for the rest of my life by going private.

Unfortunately I don't recall which injection it was, but it was a few years ago when I started this thread. May have changed since but it was definitely every fortnight.

I found that the injection meant a spike at the start then tail off before the next one, and didn't like the ups and downs of that. When discussing with my endo the other week she said the same albeit about a notionally 13 week injection (with the GP and the previous endo, they flatly denied that could be a thing) and did also say you could shorten the period albeit after a load of testing to find out when it started to tail off - but then she agreed with me that if you're ok with the gel, it's more consistent plus you can adjust the dose if you feel the need.

I had a shower and used the gel an hour ago, first thing after drying I put the gel on, washed my hands, by the time I'd got my lower half dressed the gel was dried in. Didn't delay me at all. Won't be for everyone but it works for me.

Ah yeah, I'm on Testogel, it dries waaay quicker than Tostran which I started off with. Went back to the endo and said it wasn't drying and was a right arse ache, and got switched to Testogel, and it's much better.

[Funk]

I'm booked in for the consultation/starting treatment with Mens Health Clinic early June. It feels a little like things have been 'short-cutted' a little; perhaps this is because usually there'd be time with them doing blood tests etc which I've already been able to supply. However, at this stage I've only ever spoken to their admin team (re. sending the info/booking appt) and had one email from Dr. Stevens which was to state what he's recommending; it isn't him I'll be seeing on the consultation either, it'll be one of the other doctors, Dr. Williams.

Dr. Stevens has mentioned daily subcutaneous Testosterone Cypionate and Human Chorionic Gonadotropin (HCG) injections (with links to extensive documentation on their site as to what each is etc). The cost of those treatments will be £370/qtr (£124/mo) and looking at the breakdown of everything that's provided - it's comprehensive - I don't think it's actually bad value.

I do have some questions which I'm going to get together and email over ahead of the appt. If it's what's needed then I'll do it - I guess I have to balance out "You've asked experts - this is what they recommend so go with it.." with the (perhaps slightly unfair) suspicion that they have of course have a vested interest in getting me onto treatment.

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.

Sorry if some of this seems a bit naive but it's kind of gone from 0-100 pretty quickly and I'm trying to learn/understand as much as possible before just diving in.

Edited by Funk on Thursday 16th May 18:06