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A.b

Any tips on getting NHS to take low test seriously?

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Hi - any tips on how to get NHS GP/Endo to take low T seriously?

I had a test last year, rock bottom normal levels, but was discharged and offered depression support...

 

I'm planning on having the tests repeated soon, and being a bit firmer about what I would like to be done, but if any of you have had similar experiences and overcome them it would be useful to know how!

 

thanks

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You need to be stubborn with them. Tell them the levels from the Test results are obviously low and you should be getting treatment. Ask them why they are not treating your low levels and maybe show them the NHS protocol/guidelines for treating men with low testosterone. 

If your levels are rock bottom they really have no choice but to treat you. Anything under 9 nmol/l along with symptoms is when they normally prescribe testosterone.

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Common advice I've heard is to seek out a private endo or urologist in your area who is clued up on trt then get him to diagnose you and refer you back to your own gp for continuing treatment on nhs rather than waste time trying to get an nhs endo referral. This is what I'm trying to pursue at the minute as I'm struggling to even get my gp to do a hormone blood test. 

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thanks - i'm seeing a gp today, so will push for the bloods.

Interesting Idea, using the private Endo for diagnosis... If this goes nowhere I'll give it a shot

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BSSM guidelines on sexual problems in men 2010 are your best friend. Print out a copy and take it with you but preferably print another copy out and drop it in to your surgery a week or two before your appointment for the attention of your GP.

https://www.endocrinology.org/media/1454/10-12-01_uk-guidelines-androgens-male.pdf

If they try to fob you off with the usual "you're level is 9.2 which is in range therefore your symptoms cannot possibly be due to low testosterone, have some antidepressants" you can then refer to the guidelines which say that most men below 8nmol benefit from TRT and that a trial can be offered with levels up to and bordering on 12nmol. Additionally a calculated free T of 0.225nmol is supportive evidence for needing TRT. Lots of people who fall between 8-12nmol (myself included) have a calculated free T level below this threshold yet the total T is usually "within range therefore it cannot be a problem".

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4 hours ago, charlysays said:

BSSM guidelines on sexual problems in men 2010 are your best friend. Print out a copy and take it with you but preferably print another copy out and drop it in to your surgery a week or two before your appointment for the attention of your GP.

https://www.endocrinology.org/media/1454/10-12-01_uk-guidelines-androgens-male.pdf

If they try to fob you off with the usual "you're level is 9.2 which is in range therefore your symptoms cannot possibly be due to low testosterone, have some antidepressants" you can then refer to the guidelines which say that most men below 8nmol benefit from TRT and that a trial can be offered with levels up to and bordering on 12nmol. Additionally a calculated free T of 0.225nmol is supportive evidence for needing TRT. Lots of people who fall between 8-12nmol (myself included) have a calculated free T level below this threshold yet the total T is usually "within range therefore it cannot be a problem".

Thanks for the reference doc... My appointment is tonight but I'll print it and read it in the waiting room.

Hopefully they'll arrange the bloods and that'll be step 1 done

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Tell your doctor you have severe low test symptoms that your libido is zero . Tell your gp that when you ejacuate their is no ejacuate fluid this can happen with low test . Tell your gp your sex drive is do low that it is now affecting your marriage / relationship and your are beginning to get depressed / suicidal .

Your doctor will then take you seriously 

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just for a chuckle... my levels came back as serum 12 and free 200... which is a whole 2 points above the l;ow marker

GP is still telling me i'm depressed and that it's psychological 

 

Anyway, I've pushed this 'up the chain' to my neurologist (MS perks), so hopefully she'll be able to put some weight behind my plight!

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24 minutes ago, A.b said:

just for a chuckle... my levels came back as serum 12 and free 200... which is a whole 2 points above the l;ow marker

GP is still telling me i'm depressed and that it's psychological 

 

Anyway, I've pushed this 'up the chain' to my neurologist (MS perks), so hopefully she'll be able to put some weight behind my plight!

200pmol free T? The bssm threshold for low free t is 225pmol. There is research which showed that low testosterone was common in men with MS and that aggressive trt appeared to modulate the immune response and result in a more benign disease course. These sort of findings are true for a few other autoimmune diseases too. Testosterone does alleviate autoimmunity,  this is partly why women suffer far more with autoimmunity than men.

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2 hours ago, charlysays said:

200pmol free T? The bssm threshold for low free t is 225pmol. There is research which showed that low testosterone was common in men with MS and that aggressive trt appeared to modulate the immune response and result in a more benign disease course. These sort of findings are true for a few other autoimmune diseases too. Testosterone does alleviate autoimmunity,  this is partly why women suffer far more with autoimmunity than men.

thanks dor the info - i've just taken another look at the results sheet, i'm 212 out of a range of 198 to 600, so apologies for the initial inaccuracies...

 

I'm definitely going to seek out the studies/data sources you've referenceed, they appear to be solid support for my case.

cheers

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