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mearbhall

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  1. Leger Clinic

    A GP is a General Practitioner, so they get to know a little about loads of different things when they train but after that they only get to improve their knowledge when they deal with patients. If they have never seen a young man who has the testosterone of an 80 year old man, they simply have no experience of treating one and then it comes down to the individual GP. If they play ball and refer you, it needs to be a referral to a specialist in sexual medicine / men's health such as Dr Hackett and not an Endocrinologist, solely on the basis that a specialist in sexual medicine / men's health will have a good knowledge of TRT and the implications of low testosterone whereas an Endo might have knowledge or equally might not as an awful lot of them seem to focus on diabetes. If the GP doesn't play ball then you need to see if it is possible to bypass the GP. This may mean contacting a specialist directly, or calling their secretary, to see if they could write to your GP to request you get referred. It is your health that is at stake, and you are aware of the risks with UGL's, so try every possible means to get treated on the NHS as you know you won't have to worry about sourcing TRT meds any more once you get an NHS diagnosis.
  2. Leger Clinic

    And then you wonder why the GP's turned you down? Maybe lose the wig and red nose the next time you go huh?? All you done is moan and complain because someone got treatment and you didn't. boohoo Thankfully I get Testosterone Enanthate on the NHS and if that doesn't do the job I can switch to Sustanon, as I have already been down the Nebido route. It may not be a wide selection to choose from but at least my TRT is one thing I don't have to worry about and, as I was diagnosed by an NHS specialist, I will continue to get my Testosterone for nothing via the NHS which my NHS is happy to prescribe. Do you pay for yours? You, on the other hand, have all the answers
  3. Leger Clinic

    Could you not go to a private consultant or at least find the name of one that has been recommended and send them an email to get their opinion on whether there is any hope of getting treatment on the NHS? Unfortunately Endo's are too general for TRT and most only specialise in Diabetes. Not really sure why you would go to the expense of seeing Dr S, plus yearly subscription fees, just to get a private prescription for a random brand of Testosterone, that you will then have to pay for, when you've previously gone down the UGL route and only had the cost of the Testosterone to deal with? Is there ny reason why you can't switch brands of UGL Testosterone?
  4. Leger Clinic

    I know I am, glad you've finally accepted it. Wow, it finally dawns on you. Did the OP find a specialist in sexual medicine / men's health? no, he went straight to the bloke down the road and then he's moaning cause they didn't do the work properly. Do you call him out on it? Of course not, he sounds like you. Reasons for seeing Dr S? I can't get my usual brand of UGL Testosterone. God give me strength.
  5. Leger Clinic

    Have any of your posts helped the OP in any way? The answer is no. And it's naive to suggest that because you 'pay for' the NHS you should get 'Good NHS care'. What exactly is 'Good NHS care'? We don't live in a Utopia. The NHS is a numbers came and a postcode lottery and until that changes it's up to individuals to seek out the consultant they think will give them the best care. If you had a classic Aston Martin and it broke down would you take it to the bloke down the road to fix it simply because he is a trained mechanic (and he fixed your neighbour's car and does MOT's so he must be good) or would you seek out a specialist Aston Martin mechanic to repair your pride and joy? Why does anyone go to one of your bars? Surely bars are all the same? Obvs nothing to do with the affable nature of the bloke who runs the place There are plenty of online forums that confirm your view that GP's are awful at treating TRT. Is that because the men who go online to look for answers to their health problems, and post on forums about their struggles, are generally the ones who haven't received good treatment from their GP's and are desperate to hear from other people in the same boat what they can do to get well? or do you think there are men out there who are being treated well by their GP's who will take the time to start a thread about how perfect their GP is and how their treatment is going fantastically well? When all is said and done, the NHS route needs to be exhausted before embarking on the private route. That is all I am saying. And if someone goes down the private route they still need to do their research to find a TRT Clinic that treats their symptoms and only gives them the medication they actually need, and not the medication they ask for or think they need (just because their mate is taking it and he gets 'rock hard boners'. Allegedly). Can we agree on that?
  6. Leger Clinic

    That's true other than it wan't pure luck with Dr Hackett as I researched to find out who, in my view, were the best NHS doctors in this field, in terms of the research papers they had been involved with, and he was one of 3 names, the other 2 being Dr Hugh Jones at Sheffield and Dr Adrian Heald at Salford. Dr Hackett was the closest to me so he was the one I went to see. I think we both agree that the doctor's who work in the NHS are not all the same and never will be. They all have different experiences and interests and some have more interest in saving the NHS money than they do in treating a patient with the correct medication. But, we both know that that is the situation and as far as TRT is concerned you have to do the leg work in order to get what you want out of the NHS rather than simply raving on about how rubbish the NHS is as you head off down the road to a private TRT clinic. For me, the goal was twofold - to get a diagnosis from an NHS consultant and for that diagnosis to come from and NHS consultant who was a recognised expert in the field. Once you have that, it's an awful lot easier to have discussions on TRT with a GP as they have to bow to superior knowledge whether they like it or not. Some will choose not to, possibly due to a 'God-complex', and if that is the case you have the right to complain to the GMC. At the end of the day if you don't care enough about your health to push every door, then don't complain when the GP says no. You don't care so why should they? I fully agree that getting good NHS treatment requires a lot of luck but I would also suggest your chances of getting good NHS treatment will improve if you are not blind to the realities of the NHS. As far as private treatment is concerned, it isn't always the answer. I was referred by my GP to a random NHS endocrinologist some years ago, and because his waiting list was so long decided to see him privately. I saw him 5 times in the space of 4 months and each time I would see him he would he would send me for more blood tests and tell me to come back in a month. He cost me £1150 and all I have to show for it are some blood test results. No diagnosis, no treatment plan, nothing and because I saw him privately there was sod all I could do about it.
  7. Leger Clinic

    And in my experience they were not ‘spot on’. Surely it isn’t against the rules to disagree?? Did I not give the name of the NHS consultant I saw who confirmed low T symptoms should be treated with TRT if TT levels are lower than 12 nmol/L and provide a link to one of the many papers he has written which confirms his view? In other words I backed up my statements with solid facts but hey let’s ignore that because you had a bad experience with 5 GP’s (from the same surgery??) and a GP in a bar said something that is blatantly untrue and goes against the Guidelines (which Dr Hackett wrote btw) . . . no problem, you’re obviously right. Heaven knows why the courts are so reliant on facts when hearsay is far easier to come by, huh? No surprise about the hairy chest as for me it was having a full beard that baffled my GP!
  8. Leger Clinic

    No I don't, but surely you're not suggesting that as proof to mean it doesn't happen? It obviously makes no sense to anyone suffering with Hypogonadism that they can be considered 'well' if they have a Test level of 8 nmol/L but 'unwell' with a Test level of 7.95nmol/L. I think we would both agree that the NHS does fantastic work, but it doesn't do everything fantastically well and one of its many issues is that it can stick rigidly to a diagnosis by numbers approach. My original Hypogonadism diagnosis was made by Dr Hackett, an NHS Urologist in Birmingham, and he confirmed at the time that although anything below 8 nmol/L required TRT, anything between 8 nmol/L and 12 nmol/L warranted a trial of TRT for at least 6 months for those suffering with the symptoms of low testosterone. I accept that treating patients according to symptoms is not exactly the norm when it comes to 'modern' NHS medicine but as I said in my earlier post the most important thing to do is to not accept a referral to any old doctor. Do your research, find a doctor who specialises in sexual medicine / men's health and make an appointment. If it is a private consultation, try to at least see someone with links to the NHS. As far as I am aware Dr Hackett can still be seen privately at his (home) office, is in private practice at Spire Hospital, Sutton Coldfield and Newson Health, Stratford upon Avon. I appreciate that some NHS GP's might be reluctant to even consider a diagnosis from a private doctor but given his vast knowledge on the subject, and the fact he has only recently retired from the NHS, a letter from him to an NHS GP might carry more weight than one from a private TRT clinic if the target is to get treated properly by the NHS. One of many papers Dr Hackett has written on the subject: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772354/
  9. Leger Clinic

    Call your GP surgery and ask for an appointment with the most senior / experienced GP in the practice. You could also check on their website to see which GP heads up the surgery. Explain your situation to the GP and that you are planning to see Dr S, a former NHS GP who is now a specialist GP in the field of sexual medicine who still works within the NHS for local patients. Ask the GP if they will support you with whatever testosterone treatment Dr S prescribes, but also let the GP know that you acknowledge that some treatments such as HCG cannot be prescribed by primary care and therefore will have to be prescribed privately by Dr S, if required. Hopefully they will agree to this but if not it's worth trying another GP at the surgery. If they agree, then just give the GP's name to Dr S when you have your consultation.
  10. Leger Clinic

    Appreciate your opinion, but your response is a generalisation and you've gone off on a bit of a tangent. For one, you don't know the OP's GP or what their response will be, so don't assume. Promoting a generalised, negative attitude to all NHS GP's, on the basis that the only GP you know is not what you would call a 'good' GP simply because that is your experience of that particular GP is what drives those with a medical need straight into the arms of the private clinics. First port of call should be your GP and if you disagree with their view, get a second opinion. Regardless of what the GP's view is, ask to be referred to an NHS consultant in sexual medicine / men's health and if your GP won't refer you, see an NHS consultant privately. In other words, exhaust every option to get treated on the NHS before going down the private TRT clinic route. And for two, <8nmol isn't the benchmark in every part of the UK and even where it is you will still find an NHS consultant specialising in sexual medicine / men's health who treats patient's based on their symptoms rather than blood results. The name of the game is to find a specialist in sexual medicine / men's health, not an endocrinologist who specialises in diabetes! Getting back to the OP and my previous post: The OP has been self-administering TRT for a number of years. Either way, it doesn't sound like the medication has come from a 'legal' source and doesn't sound like the NHS option has been tried. If we assume that the NHS is not an option, the OP might well go to a private TRT clinic and walk away with a private prescription for Test E or Sustanon. As the OP has been pinning Test Cypionate for some time, Test E may be the preferred choice given it is very similar to Test C. They may well also get a private prescription for HCG. From discussions we have already had, we both know that the 'legal' route for these medications will be the safest and preferred route but it may not be the cheapest route. If the cheapest route ends up being the preferred route then what exactly will be gained by going to a private TRT clinic? A piece of paper that's cost you a few hundred pounds? From the OP's posts it appears that they have a clinical need for TRT based on symptoms, TRT has made a positive difference to their life, they want to continue with it, they know what bloods they need to keep an eye on and they are comfortable with managing the treatment. As Test E can be interchanged with Test Cypionate and both can be obtained from 'non-legal sources', if the OP has not been using the 'legal' route to get meds for the last couple of years then the same question applies . . . . what exactly will be gained by going to a private TRT clinic? That is why I asked about the NHS route and from what I can see the OP has absolutely nothing to lose by discussing the issue with their GP, but all to gain (from NHS blood tests to potentially getting an NHS prescription for their meds).
  11. Leger Clinic

    Just out of interest, if Dr S writes to your GP and confirms that you have a clinical need for TRT, is your GP likely to write you an NHS prescription for Sustanon or Enanthate? And will the GP let you self-inject?
  12. Leger Clinic

    Just send him an email, explain your situation and your concerns about making an appointment and ask him whether he will be able to help. I had a telephone consultation with him a few weeks ago. He is very approachable and, unlike most doctors I’ve dealt with, he is happy to discuss all treatment options and will listen to your point of view, rather than steam roller you into accepting whatever treatment is the flavour of the day.
  13. He said he’s going to send me info on doses in the post along with instructions for giving injections so, as you say, I’ll see what he’s prescribed and take it from there. Had a look at a few yesterday and prices were consistently around £25 for 5000iu. Is that around ballpark or should I look harder? And I guess there’s no real difference from brand to brand? Bayer, Ogivil, Organon, Magnus and SP all seem to be generally available but haven’t seen Gonasi anywhere.
  14. Would you say it is best to start with once a week or twice a week - twice a week sounds like the peaks wouldn’t be too high and the troughs wouldn’t be too low but not sure if that’s the reality? It was Fertility2u. Dr S said it worked out around £30-£40 per month for Gonasi so that pretty much equates to £150 for 20 weeks. Any chance you can give me a steer on where to find it cheaper, or is that not allowed on here?
  15. I sent a link to the Leger Clinic website over to my GP last week and he's just emailed to say he's "done some research on TRT and Dr S and he seems ahead of the crowd". He then told me to make an appointment with him and that whatever he is permitted to prescribe on the NHS - which rules out HCG & Clomid - he will do his best to prescribe. Sounds hopeful but as my local CCG are a complete pain in the a*** when it comes to prescribing anything not on their Formulary it could go either way! If it comes to that there are only three options available, Testogel, which I tried for 5 months, Nebido, which I've been on for almost 3 years or Sustanon. Guess it could be worse, so should be grateful there's at least another injectable testosterone! On the NHS NICE website there are just three manufacturers listed (but I think they are all part of Alliance Pharmaceuticals) for 'Testosterone enantate 250mg/1ml solution for injection ampoules' and you get 3 ampoules in a pack. He said 0.5ml once a week or 0.25ml twice a week so I guess that's 125mg every 7 days or 62.5mg every 4 days? Sounds a lot or is that likely to be just a starter dose until levels get dialled in? No I didn't ask him as he had no objection to prescribing Test E. It's not that I have anything against Sustanon but as I have so much other s*** going on, and my thyroid levels are finally where they need to be, I would prefer to keep my TRT as simple as possible so I can essentially track the cause and effect of whatever testosterone compound I take. For me that means a single ester like Test E rather than a mix of esters such as Sustanon. I am waiting for the fertility website Dr S suggested for HCG to come back to me regarding stock and cost as they seem to be the only place with it 'in stock', but that's only according to their website. How do I find a legit UGL if I need to go down that route in the future?
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