Low testosterone

[PArbor1]

I’ve now got the 90 min consult at the Mens Health Clinic on 27th Oct, so fingers crossed I’ll be coming home with testosterone. Over email they have recommended the micro dosing, so I’d be administering it every day.

[BoloH4wes]

Hi gents, i've had some of the typical symptoms of low T (Fatigue, low motivation and difficulty concentrating, irritability, fat gain, ED etc) which isn't great at 39 years old.

So I tried out a Numan finger prick test - that came back as possible Low T (7.17 nmol/L). I spoke to my GP who wasn't that interested but sent me off for a blood test, that's now come back as normal (9.5 nmol/L) no action required but it looks low to me? I have little faith that i'll get anything done on the NHS so I think the next step is to go private - can anyone reccomend a good clinic in London who could take a look at my results?

My results are below, maybe i'm barking up the wrong tree!



Values and Investigations (Latest Value)

03-Sep-2022 HbA1c levl - IFCC standardised - (SShaw) - Normal Result: No Action Required 28 mmol/mol 20.00 - 41.00mmol/mol

03-Sep-2022 Serum cortisol - (SShaw) - normal 285 nmol/L 101.00 - 536.00nmol/L
In adults not on steroid treatment, <100 nmol/L
suggests adrenal insufficiency, >400 nmol/L makes
adrenal insufficiency unlikely, 100 - 400 nmol/L
consider short synacthen test if there is a strong
clinical suspicion of adrenal failure.

03-Sep-2022 LH & FSH - (SS) - Normal Result: No Action Required
Luteinising Hormone 2.4 IU/L 0.60 - 12.10IU/L
Serum FSH level 5.3 IU/L 1.00 - 12.00IU/L

03-Sep-2022 Urea and electrolytes - (SS) - Normal Result: No Action Required
Serum sodium 140 mmol/L 136.00 - 145.00mmol/L
Serum potassium 4.2 mmol/L 3.50 - 5.10mmol/L
Serum urea level 6.2 mmol/L 3.20 - 7.40mmol/L
Serum creatinine 83 umol/L 63.00 - 111.00umol/L

03-Sep-2022 THYROID STIMULATING HORM. - (SS) - Normal Result: No Action Required
Serum TSH level 1.58 mIU/L 0.35 - 4.94mIU/L
Comment
Euthyroid or adequate replacement.
Rarely, patients with pituitary/hypothalamic
hypothyroidism can have a normal TSH.

03-Sep-2022 Serum testosterone - (SS) - No bacterial infection found 9.5 nmol/L 8.30 - 30.20nmol/L

03-Sep-2022 LIVER FUNCTION TESTS - (SS) - Normal Result: No Action Required
Serum ALT level 20 U/L 10.00 - 35.00U/L
Serum bilirubin level 21 umol/L 0.00 - 21.00umol/L

03-Sep-2022 HDL AND CHOLESTEROL - (SS) - Normal Result: No Action Required
Serum cholesterol 4.1 mmol/L
Serum HDL cholesterol level 1.1 mmol/L
Cholesterol/HDL ratio 3.7
Se non HDL cholesterol level 3 mmol/L
Guide to Lipid Interpretation:
~
Primary Prevention:
Refer to risk tables
Secondary Prevention:
Target Cholesterol < 4.0 mmol/L
or 25% reduction (whichever is greater)
Target LDL-Cholesterol < 2.0 mmol/L
or 30% reduction (whichever is greater)
HDL Cholesterol should be > 1.0 mmol/L
Target non HDL Cholesterol <2.5mmol/L (JBS3 2014)
or 40% reduction from baseline (NICE CG181/July 2014)
Fasting Triglyceride should be less than 1.7 mmol/L

03-Sep-2022 ! FULL BLOOD COUNT - (SS) - Satisfactory : No Action Required
Haemoglobin estimation 155 g/L 130.00 - 180.00g/L
Total white cell count 6.7 10*9/L 3.70 - 11.0010*9/L
Platelet count 350 10*9/L 150.00 - 450.0010*9/L
Neutrophil count 3.5 10*9/L 1.70 - 7.5010*9/L
Lymphocyte count 2.3 10*9/L 1.00 - 4.0010*9/L
Monocyte count 0.4 10*9/L 0.20 - 1.0010*9/L
Eosinophil count 0.4 10*9/L 0.04 - 0.5010*9/L
Basophil count 0 10*9/L 0.00 - 0.1010*9/L
Red blood cell (RBC) count 4.82 10*12/L 4.50 - 6.0010*12/L
Haematocrit 0.423 L/L 0.39 - 0.50L/L
Mean corpuscular volume (MCV) 87.8 fl 80.00 - 100.00fl
! Mean corpusc. haemoglobin(MCH) 32.2 pg 27.00 - 32.00pg
! Mean corpusc. Hb. conc. (MCHC) 366 g/L 320.00 - 360.00g/L
Nucleated red blood cell count 0 10*9/L 0.00 - 0.0110*9/L

03-Sep-2022 BONE PROFILE - (SS) - Normal Result: No Action Required
Serum total protein 74 g/L 64.00 - 83.00g/L
Serum albumin 47 g/L 35.00 - 50.00g/L
Serum calcium 2.38 mmol/L 2.10 - 2.55mmol/L
Serum inorganic phosphate 0.9 mmol/L 0.80 - 1.50mmol/L
Corrected Calcium 2.24 mmol/L 2.10 - 2.55mmol/L
Serum globulin 27 g/L 20.00 - 39.00g/L
Serum alkaline phosphatase 57 U/L 40.00 - 150.00U/L

[cqueen]

9.5 isn't normal. You do have low T, especially when combined with your symptoms. NHS won't be interested, go private.

Edited by cqueen on Friday 9th September 10:23

[272BHP]

cqueen said:

9.5 isn't normal. You do have low T, especially when combined with your symptoms. NHS won't be interested, go private.

Edited by cqueen on Friday 9th September 10:23

This.

[Scabutz]

I had similar levels to those. First NHS GP wasnt interested and as soon as one test was slightly over the threshold that was it. I saw a different NHS GP and she referred me straight to the endo who has seen me once a year ever since.

Yes private is probably the best option but if cost is prohibitive its worth trying an alternate NHS route if you can

[xx99xx]

They missed off SHGB from the test which would've been useful in your situation.

The problem with the NHS is that they focus on the numbers (and whether they're within the lab 'normal' range) and not the patient's symptoms. It's easier for GPs to suggest lifestyle changes and say come back in 6 months. I understand why they'd do this as lifestyle could be the cause of these symptoms in some cases but where it isn't, it creates a long delay in getting any treatment as they don't do additional tests until lifestyle has been ruled out.

[BoloH4wes]

Thanks for confirming, it does feel like i'm getting the typical NHS treatment for this type of thing!

I've given Optimale a shout as they seem like the most transparent in terms of pricing and the online reviews are good.

[MOBB]

I've got all of the usual symptoms, aged 50, in early 2021 my reading was 9.6, 6 months later 12

I was told this is ok, should I reconsider?

[BoloH4wes]

xx99xx said:

They missed off SHGB from the test which would've been useful in your situation.

The problem with the NHS is that they focus on the numbers (and whether they're within the lab 'normal' range) and not the patient's symptoms. It's easier for GPs to suggest lifestyle changes and say come back in 6 months. I understand why they'd do this as lifestyle could be the cause of these symptoms in some cases but where it isn't, it creates a long delay in getting any treatment as they don't do additional tests until lifestyle has been ruled out.

I had an SHBG of 13 nmol/L but that was from a finger prick test so appreciate it might not be that accurate

[xx99xx]

BoloH4wes said:

I had an SHBG of 13 nmol/L but that was from a finger prick test so appreciate it might not be that accurate

Yeah not totally accurate but a good indication. 13 isn't too bad so won't impact your available Testosterone very much. You want to avoid high SHGB and low testosterone (not that you can do much about it!).

It took me about 10 years on the NHS route to get treatment and even then I think I got lucky in the end as my GP at the time was nearing retirement and was probably losing interest in saving money and sticking to guidelines! She prescribed testogel without even referring me to an endo which I think is quite rare.

[jm8403]

Did you guys who got medication find the symptoms went away with meds then?

[pidsy]

jm8403 said:

Did you guys who got medication find the symptoms went away with meds then?

Yes. It’s not particularly cheap but very worth it in my case.

[xx99xx]

jm8403 said:

Did you guys who got medication find the symptoms went away with meds then?

To some extent. Not completely but better than vs no medication. So I took that as a win and gave up pursuing it further.

[Scabutz]

jm8403 said:

Did you guys who got medication find the symptoms went away with meds then?

In short yes, but its much more complex than having a headache, taking a paracetamol, and the headache going.

Some symptoms I saw a big improvement initially, but the improvement reduced over time. Others took longer to see improvement but were more stable. There was also a few ups and downs. Particularly early on when they adjusted the dose, took a while to settle.

[firemunki]

Recently had a reminder for my you're now definitely not a young 'un anymore NHS health check.

Google hasn't supplied any answers but I reckon someone here might be able to help, does a normal blood test include checks for low T?

Some symptoms described here ring too many bells and I'd like to know/rule stuff out.

[272BHP]

firemunki said:

Recently had a reminder for my you're now definitely not a young 'un anymore NHS health check.

Google hasn't supplied any answers but I reckon someone here might be able to help, does a normal blood test include checks for low T?

Some symptoms described here ring too many bells and I'd like to know/rule stuff out.

Pay for a blood panel yourself. The very act of paying with your own money means you will start taking ownership of this stuff.

[xx99xx]

firemunki said:

Does a normal blood test include checks for low T?

No. And you can't just ask on the day to add it on either.

You could see GP before your blood test and ask to include testosterone (and SHBG) on your forthcoming check up, based on symptoms. Or go private.

[MOBB]

Just had a new test done as part of my Medichecks annual thing, I've lost a fair amount of weight and got much fitter in the last 12 months which has sorted a pre-diabetic issue amongst others.

Jul 21 - 9.6 nmol/L
Feb 22 - 12 nmol/L
Sep 22 - 7.24 nmol/L

I was not expecting that last result, as the Feb 22 figure had improved and I have been looking after myself, including weight training, I thought it would go up if anything.

As I'm knackered all the time etc etc its time for something to be done.

[Scabutz]

MOBB said:

I was not expecting that last result, as the Feb 22 figure had improved and I have been looking after myself, including weight training, I thought it would go up if anything.

I discussed this with my endo when I first had it, I said I had lost weight, lifting weights doing those things to improve testosterone levels. She said that would only have a small improvement on someone whose body was producing the normal levels of testosterone, if it doesnt work properly to begin with then the only thing that helps is taking it synthetically.

[PArbor1]

So, today was the day that I finally started treatment for testosterone deficiency at the Mens Health Clinic.

My protocol is 12.5mg/0.1ml testosterone Cypionate, 1000iu/0.1ml HCG and 5mg Tadalafil.

Injection wise, I was really surprised that I didn’t feel either of the injections but I will have to see how it goes injecting myself on my own in the morning.

I’ll try and keep you up dated on progress etc and how I’m finding things.

The MHC are a really friendly bunch, and I’d recommend anyone suffering from low test symptoms to get in contact and heed the advice throughout this thread and just don’t bother with the NHS. I thought my Dr was understanding but in reality, it waisted time and I could have been six months in now.

Cheers Dr stevens &#128521;