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Krk

TRT advice.

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I recently turned 40 and I’ve been on escitilipram and mirtazipine for just over a year. I have symptoms of low test. My sex drive is nowhere near what it was and I’m generally lethargic.
 
I recently had had a blood test due to my brother being diagnosed with hemacromotosis. I asked the doctor about my test levels and he said they were perfectly “normal’”.
 
I was suprised, as I done a course of epistane in 2012. I had no idea what it was. It was sold over the counter in a supplement store and I was told no pct was necessary. I guess I’ve been paranoid ever since.
 
I decided to get a quote for private TRT and HCG. I’ve been quoted £90 per month for TRT and a extra £35 for HCG.
 
Is this a fair price?
 
Any advice would be appreciated. Ive had a rough few years and need to get my **** back on track.
 
Thanks.

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13 hours ago, Krk said:

I recently turned 40 and I’ve been on escitilipram and mirtazipine for just over a year. I have symptoms of low test. My sex drive is nowhere near what it was and I’m generally lethargic.
 
I recently had had a blood test due to my brother being diagnosed with hemacromotosis. I asked the doctor about my test levels and he said they were perfectly “normal’”.
 
I was suprised, as I done a course of epistane in 2012. I had no idea what it was. It was sold over the counter in a supplement store and I was told no pct was necessary. I guess I’ve been paranoid ever since.
 
I decided to get a quote for private TRT and HCG. I’ve been quoted £90 per month for TRT and a extra £35 for HCG.
 
Is this a fair price?
 
Any advice would be appreciated. Ive had a rough few years and need to get my **** back on track.
 
Thanks.

im guessing this is optimale right? they are pricey but conveniet..... if you have low testostrone and have recent blood work dr savage will help at doncaster he charges 59 for testostrone and 25 i think for hcg 

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The ironic thing is I believe opimale use dr savage as their consulting doctor - least that’s what I have read. Much better going straight to dr savage who is excellent. I believe he is bringing in a monthly or year charge to manage trt guys this year - still much cheaper than optmales prices 

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Before you do anything you need to know what your levels are. Private trt companies will prescribe you hormones whether you need them or not.

Get a hormone panel done with medichecks or forthwith life and go from there.

edit - total test, free test, e2, shbg, and prolactin are what needs testing 

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17 hours ago, Rockstar618111 said:

Far to expensive - what company was it?

 

6 hours ago, lowttt said:

im guessing this is optimale right? they are pricey but conveniet..... if you have low testostrone and have recent blood work dr savage will help at doncaster he charges 59 for testostrone and 25 i think for hcg 

 

6 hours ago, Rockstar618111 said:

The ironic thing is I believe opimale use dr savage as their consulting doctor - least that’s what I have read. Much better going straight to dr savage who is excellent. I believe he is bringing in a monthly or year charge to manage trt guys this year - still much cheaper than optmales prices 

Yes it was optimale. 

 

I ‘I will give dr savage a whirl. Thanks. 

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5 hours ago, Sasnak said:

Before you do anything you need to know what your levels are. Private trt companies will prescribe you hormones whether you need them or not.

Get a hormone panel done with medichecks or forthwith life and go from there.

edit - total test, free test, e2, shbg, and prolactin are what needs testing 

I recently had a blood screening done. Everything was “normal” except for height ferritin (iron). 

I guess my symptoms are “normal” for my age. 

I just need the boost that only test can give. I’m nervous about HCG as I’ve read it can cause gyno?

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30 minutes ago, Krk said:

I recently had a blood screening done. Everything was “normal” except for height ferritin (iron). 

I guess my symptoms are “normal” for my age. 

I just need the boost that only test can give. I’m nervous about HCG as I’ve read it can cause gyno?

if you hvae a dr that is treating you you wont get gyno because they are doing blood test to keep things in check.. whats your results? because dr savage wint treat you if you dont need it... if you just want to get on trt witch i dont think you should if you are normal then optimale will accept you because its a middle man and they want money 

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30 minutes ago, Krk said:

I recently had a blood screening done. Everything was “normal” except for height ferritin (iron). 

I guess my symptoms are “normal” for my age. 

I just need the boost that only test can give. I’m nervous about HCG as I’ve read it can cause gyno?

“Normal” can also mean sub-optimal, especially with the NHS and whilst they do a great job, there is seemingly evidence that they don’t always get hormones right at general practice level.

Do you know your actual numbers?

Hcg can cause gyno but probably unlikely to do so. I’m currently running it alongside 300 test without ai and I’ve had no issues but everyone is different. Hcg won’t “cure” you afaik, it’ll only potentially increase test levels for as long as you are on it.

Again, you need to find out your numbers and decide whether to stay natural or go down the trt route. Obviously trt is a one way street.

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1 minute ago, lowttt said:

if you hvae a dr that is treating you you wont get gyno because they are doing blood test to keep things in check.. whats your results? because dr savage wint treat you if you dont need it... if you just want to get on trt witch i dont think you should if you are normal then optimale will accept you because its a middle man and they want money 

I did consider doing a cycle of test, but I was unsure about the sources and read about fake gear. 

My gp says my test levels are “normal” but the normal range is quite wide. I’ll contact them to find out  

Im planning on doing a cycle of turnibol once I start TRT.

 

 

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2 minutes ago, Krk said:

I did consider doing a cycle of test, but I was unsure about the sources and read about fake gear. 

My gp says my test levels are “normal” but the normal range is quite wide. I’ll contact them to find out  

Im planning on doing a cycle of turnibol once I start TRT.

 

 

your life your choice but honestly im 28 and i have test level of 6.5nmol my last results and the range from nhs is 7 nmol to 29 nmol they still wont help me... i would never go on steroids becuase you dont know what your getting and in the end your lose most of your muscle anywasy .... your choice 

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3 minutes ago, Krk said:

I did consider doing a cycle of test, but I was unsure about the sources and read about fake gear. 

My gp says my test levels are “normal” but the normal range is quite wide. I’ll contact them to find out  

Im planning on doing a cycle of turnibol once I start TRT.

 

 

At best you’ll get total test and free test. Free test is the most important figure not the total. See what they say and get back to us 

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2 minutes ago, lowttt said:

your life your choice but honestly im 28 and i have test level of 6.5nmol my last results and the range from nhs is 7 nmol to 29 nmol they still wont help me... i would never go on steroids becuase you dont know what your getting and in the end your lose most of your muscle anywasy .... your choice 

You need to see another doctor then. I don't know much about trt but know that level is very low. How many times has it been tested and was the blood test done early morning after a good nights sleep with no alcohol the day before?

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The thing is mate your on medication which both causes lethargy and low sex drive. Additionally the mental health issues that require this kind of medication can cause symptoms that you describe.

Going on TRT is a lifelong commitment and jabbing forever gets old, real fu**ing fast - take it from someone who has to be on for life, I wouldn't choose it for anyone who doesn't need it.

Honestly get your levels back and see what you think and only go ahead if you really need it.

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18 minutes ago, monkeybiker said:

You need to see another doctor then. I don't know much about trt but know that level is very low. How many times has it been tested and was the blood test done early morning after a good nights sleep with no alcohol the day before?

iv had 4 test numbers 7.44nmol 8nmol 10nmol then most recent 6.5nmol all done by doctors and endo from nhs they dnt want to help so booked appointment with dr savage but i also emaiedl all my results to prof hakett he contacted my gp and my gp wants to see me so hopfuly they will listen because ei feel like death lol

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7 minutes ago, lowttt said:

iv had 4 test numbers 7.44nmol 8nmol 10nmol then most recent 6.5nmol all done by doctors and endo from nhs they dnt want to help so booked appointment with dr savage but i also emaiedl all my results to prof hakett he contacted my gp and my gp wants to see me so hopfuly they will listen because ei feel like death lol

6.5 at 9am with a good night's sleep and no booze?

if that's consistently at that level you WILL be prescribed TRT by the NHS.

7.4 is borderline low and 8 and 10 are fine really.

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7 minutes ago, Lifesizepenguin said:

6.5 at 9am with a good night's sleep and no booze?

if that's consistently at that level you WILL be prescribed TRT by the NHS.

7.4 is borderline low and 8 and 10 are fine really.

it was 9.20am and i hardly ever drink i think last time i was drunk was 3 months ago lol and teh endo said that i am low im just unlucky and thaty i should try and relax and do deep breathing lol they alsdo saw my lh was 1.7 so they did a mri on me but dntno the results they will see me in 6 months lol 

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4 hours ago, Lifesizepenguin said:

6.5 at 9am with a good night's sleep and no booze?

if that's consistently at that level you WILL be prescribed TRT by the NHS.

7.4 is borderline low and 8 and 10 are fine really.

Not according to the bssm guidelines. 8 is borderline clinically low,  10 is near as damn it. Levels up to 15nmol are a risk factor for low t symptoms. 

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13 hours ago, Lifesizepenguin said:

The thing is mate your on medication which both causes lethargy and low sex drive. Additionally the mental health issues that require this kind of medication can cause symptoms that you describe.

Going on TRT is a lifelong commitment and jabbing forever gets old, real fu**ing fast - take it from someone who has to be on for life, I wouldn't choose it for anyone who doesn't need it.

Honestly get your levels back and see what you think and only go ahead if you really need it.

this is the only post you need.

TBh it just sounds like you think free test will be a great idea , its not .

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On 06/01/2019 at 12:08 AM, charlysays said:

Not according to the bssm guidelines. 8 is borderline clinically low,  10 is near as damn it. Levels up to 15nmol are a risk factor for low t symptoms. 

15nmol? get out of here with that s**t.

I think they only prescribe TRT on NHS for lower 7.6nmol by memory.

mate if 10 is near enough id feel like crap every 5 weeks when I drop below 10nmol. youll only get those levels on TRT mate.

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55 minutes ago, Lifesizepenguin said:

15nmol? get out of here with that s**t.

I think they only prescribe TRT on NHS for lower 7.6nmol by memory.

mate if 10 is near enough id feel like crap every 5 weeks when I drop below 10nmol. youll only get those levels on TRT mate.

Quoted from BSSM guidelines 2010:

Page 5: "Whilst there are no generally accepted lower limits of the normal range for testosterone, there is general agreement that a testosterone level above 12nmol/l do not require replacement"

page 7 "The aim of therapy should be a total testosterone level of atleast 15nmol to ensure symptomatic improvement" and "normal concentrations" (page 10)

page 7 "in the presence of a clinical picture of testosterone deficiency and borderline serum testosterone levels, a short therapeutic trial (e.g up to 6 months) of testosterone may still be justified"

Page 3 of the ISSM guidelines:

" The prevalence of hypogonadal symptoms increases with
TT levels below 12.1 nmol/L (350 ng/dL) [26] (Level 2b,
Grade A). However, Zitzmann et al. have shown that
testosterone deficiency symptoms may also be seen with TT
levels as high as 15 nmol/L. This study showed that the
prevalence of loss of libido or vigor increased at testosterone
concentrations below 15 nmol/L (
p50.001), whereas depression and T2DM (also in non-obese men) were significantly
more prevalent in men with TT concentrations below
10 nmol/L (
p50.001). ED has been identified as a composite
pathology of metabolic risk factors, smoking and depression,
whereas only TT concentrations below 8 nmol/L contributed
to that symptom (
p ¼ 0.003). Behre et al. [14] demonstrated
that 6 months of TRT improved body composition and quality
of life in men aged 50–80 years with TT
515 nmol/L and
hypogonadal symptoms; these men showed further improvements in body composition and quality of life over the
following 12 months of TRT. Lower TT levels have also been
shown to be associated with sub-threshold symptoms of
anxiety and depression [67]. There is also a recent study
reporting increased hypogonadal symptoms in younger
men
40 years with TT below 400 ng/dL (13.9 nmol/L) [68]"

From the above it looks as though there is no general agreement that levels as high as 12nmol don't require TRT in the presence of symptoms. In addition levels as high as 15nmol must be a risk factor for low T symptoms or the guidelines would not say to maintain a TT level of atleast 15nmol to "ensure symptomatic improvement" and "normal concentrations" (page 10).

Research published in the ISSAM guidelines also found that men with TT levels below 15nmol had increased symptoms of TD which then resolved once on TRT. In addition another study also published in the ISSAM found that levels below 13.9nmol in younger men were associated with TD symptoms.

With regards you feeling fine with a 10nmol/l trough reading, I'm sure you do. The reason for this is that your peak and average levels are way above this- I would bet your average levels are well over 15nmol/l. A natty who tests at 10nmol/l has a peak reading of 10nmol and a trough level possibly up to half that. They have a trough every single day and as such their average level is much lower than someone on TRT who will have troughs days, weeks or months apart. The only way you can compare symptoms vs levels between someone on TRT and someone not on TRT is to measure their peaks and troughs and work out their average level of testosterone. Any other comparison is not scientific due to not accounting for the variation in levels.

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On 06/01/2019 at 8:49 AM, aqualung said:

this is the only post you need.

TBh it just sounds like you think free test will be a great idea , its not .

Why not?

Surely it improves recovery and general health/condition?

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10 minutes ago, aqualung said:

it may do the above if you actually have low testosterone and need it ,if you dont its just stupid.

I thought a test boost at 40 would benefit every guy as it naturally reduces?

It’s not like I’m self injecting at 21. 

Why would it be stupid?

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