Low T at 24, UK- Private Route

Pharma TRT
1

Having read a number of posts hinting that the NHS is at best unprepared to deal with patients with low t levels (especially the younger lot) I thought I’d save myself a bit of time by taking the private care route. I am 24 and, rather unsurprisingly, my t levels came back not even within the low end of the range but below it. I’m sitting at 7.9 of total test (no free t test done despite my request) with the range being 10-37. My gp seems to want to put me on some t patches but I am quite sure it will shut me down if done on its own. Do you think that this could be avoided with sth like nolvadex/AI?

If money wasn’t the issue, what specialist would you like to see in the UK? What sort of fees do they command? I am based in the North West but can travel if need be.

Sadly I don’t have ANY other results because I was told that everything else was within range… Never thought that they even skimp on the printing paper over here!

My stats:

Age 24
Facial hair: it is anything but thick I can get away with shaving every other day. also, it’s a bit patchy.
Body hair: Not the most hairy mofo, I grow rather little hair on my chest. Moderate amount on the rest of my body, not much on my arms. Only legs grow a bit what I would consider average amount of hair

Height: 181 cm
Weight: 94kg

Body type: Athletic but carrying too much fat around my waist.
Diet: In check. A lot of eggs, berries, salmon, chicken, brown rice, potatoes, green veggies, healthy fats. No dairy, wheat or gluten. Shooting for 250 gms of protein every day, about 120 fats and 150 carbs.

Training: Hit the gym every other day, usually 4 times a week. Not as strong as I should be though which is hardly surprising given my ultra low t levels. TBH I am rather happy with my strength considering t being so low but I am sure that my body composition would have been much less soft with optimal t levels.

RX: None.
Supplements: coq10- one of few supps that me feel very good, sadly it never lasts long. I use 0.3 to 0.5 gms a day. Tyrosine, ALCAR, EAA and Surge Workout Fuel on workout days. Krill oil, vit d3 and k2, zinc, magnesium, 0.3 gm of melatonin and 3 gms of taurine before bed. Udo’s Probiotic once every day.

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From what I heard they use Nebido in the UK. Injection once every 2 months, something ridiculous like that.

Some guys say it is awesome and say it is made to be injected like that. Logically thinking why not at least split that 1000mg shot up into 10x 100mg injections and inject weekly.

I got beaten into the ground just because I raised a point on another forum. Apparently that would be going backwards haha.

Anyway I think that is about all that is available in the UK, don’t think they script hcg.

If you go down the path of trt in the UK you could ask for self injections if you don’t want to do the 1 shot every 2 months but whether they allow it is the question.

Before jumping on though you might want to exhaust a few more avenues if you really need trt, probably more tests according to the stickey would be a start.

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I think they wanted to start me off on the patches, but never mentioned any serm/AI.

Low T levels at my age are particularly worrying, at this age only intelligence and responsibility should be low.

I suppose an injection once every two months is of little benefit. Never heard of Nebido. Do you think that there is a need for estrogen control with such rare injections, say once every 8 weeks?

What avenues are you referring to? I was thinking clomid but I am not sure if I can get it prescribed here plus a lot of people do not seem to notice any cognitive/well-being boost despite an increase in their t levels.

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Hi mate what other symptoms did you have? I am 25 and in the UK. I have poor facial hair, like no upper body hair. Quite weak for my size, and had zero muscle at all before i started training. Was it really noticeable in terms of libido etc?

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The guys think no ai needed and when asked how often they are getting blood work usually before the next injection. So they would not even know what their e2 is doing in the weeks before.

I would definitely be monitoring e2 levels and honestly it just sounds stupid to inject once every 2 months.

If you can’t get a prescription for a serm or ai send me a pm with your email might be able to send you in the right direction. My pm’s are not working, can’t send.

If thinking about serm restart get lh,fsh checked to see where you at now. Probably for long term not the best idea a trial run okay to see if your boys respond when requested.

Might have to watch e2 when on a serm especially clomid had some issues with high e2.

UK is pretty cool with meds so I hear. Apparently testosterone all legal for personal use.

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I will shoot you a PM if I cannot get any serm/AI prescribed. Thanks for your input mate

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stinger, I do have a host of low t symptoms. What brings me down the most is the mental fog, apathy, lack of motivation and energy. In terms of strength I would say decent but nothing to write home about, if anything I would say I am stronger than I look because it is hard for me to build any appreciable amount of muscle mass without getting a bit flabby.

I can make myself functionable with a high dose of tyrosine and Coq10 but it is still 80%, like someone said it’s like you know you have a Ferrari engine under the hood but cannot launch it… Whenever there is someone in position of authority I feel anything but dominant and my anxiety kicks in.

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OP: You need to test LH & FSH to see if your pituitary or testes are the problem. DO NOT start TRT until you get this lab work done. You cannot do this after starting TRT.

You need to test prolactin to detect if the problem is caused by a prolactin secreting adinoma. In the advice for new guys sticky, there was also a related comment re peripheral vision.

Fertility is a major concern.

Rx=none, but what about over the counter drugs [OTC].

Have you checked body temperatures, see the sticky. Should test TSH.

Test DHEA-S

Can you post cholesterol numbers and ranges? Low cholesterol is a problem!

Accidents, blows to the head or whiplash?

9

I don’t think that low cholesterol is an issue. My dietary intake of cholesterol is rather high, I have 6 whole eggs every morning and I eat dark chocolate 85%, butter, steak and coconut oil pretty much every day.
I remember taht in the past my dhea was found to be low, even outside the range. Don’t want to speculate on the current blood work, I am going to see my practice tomorrow and collect all the results.
Same goes for LH and FSH and prolactin, but I am sure that those have been tested and most likely came back within the range because the doc told that it is only ast [liver] and testosterone taht are abnormal.

RX OCT: I also take PSerine and tyrosine pretty much every day. Not sure if it affects anything?

10

Hi mate- sorry to hear of another North West guy in their twenties struggling.

Agree with KSMan on the testing. Sounds like your levels are similar to where mine were last June.

Ok brief questions-

*Are your hands and feet noticeably cold?

*Take your oral temperature on getting out of bed and post it here -

*Hows your training been - hours/intensity/ cardio or weights? Been cutting or bulking?

*Hows your alcohol intake? Recreational drugs?

*Hows your digestion / bowel movements - any constipation or loose stools?

*Hows your mood? Any perceived stressors - deaths in family, relationshop breakdowns, work/ money worries?

*Hows your libido? Morning erections? Spontaneous erections?

*Any pain or lumps on testicles? Any trauma to them?

*Hows your sleep? Sleep in a dark room with comfortable temperature?

*Any other health conditions?

Diet sounds OK

You need the results of:

Total T
Free T / Bio available T
SHBG
E2
DHEA
Cortisol
LH
FSH
Prolactin

An endocrinologist should run most of those if you insist. I’d also see if they’ll run iron studies.

I’d maybe look into a 24 hour salivary cortisol test - google Smart Nutrition.

Depending on your FSH / LH levels your endo may suggest an MRI of your pituitary as mine did.

Do all of this before you even consider clomid/ hcg or TRT.

Don’t think you’ve mention either - have you ever used AAS?

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  • the circulation in my extremeties is fine. I do get cold feet only if I take too much Alcar for too long which can slow down thyroid

  • digestion is rather good. I take a quality probiotic and it seems to be doing its job. Every morning I also have warm water mixed with freshy squeezed lemon juice as per John Meadows suggestion

-sleep is a bit of an issue, at least till recently. I would get up several times during the night and experimented with a number of supps to help me fall and stay asleep. Recently I have found m groove with 0.3 gm melatonin and 4 gms of taurine along with 300 mg chelated magnesium. I got the biggest sleep aid out of good sleep hygiene though. I noticed that my sleep is much better when I don’t do anything in the bedroom apart from sleeping and having sex. Recently got some dark curtains whick block out any light coming from the outside so it is really pitch dark.
-never touched a single roid or ph

-mood is rather low. I get a boost out of alcar, tyrosine and frankly cannot imagine my life without em. Without them I feel flat, unmotivated and not with it if you know what I mean. Anxiety is an issue because it gets to me that I am struggling to cope with everyday adversities. Rhodiola and bacopa help in this regard. I do not really feel depressed or at lleast not as much as I used to, I would describe my state of mind as apathy.

-stressors: just graduated from a rather intense MA course and work as a freelancer so there’s always a bit of insecurity around the corner, financial or otherwise, Pserine helps to take the edge off at night. I would say I also feel stressed out because I feel I’m not 100% and struggling to bring my A game to the table. Thing is, A game is a prerequisite in my line of work as I work as a conference interpreter.

-I don’t drink apart from the cheeky pint of Guiness once a month if that, no drug use history

-training; used to train twice a day 2 years ago bt lasted only 2 weeks, so switched back to training once a day every day. Since last year I only go 4 times a week becasue of the time constraints. In terms of cardio, I sprinted and did sleg dragging 2 3 times a week 2 years ago. Last year I kept my cardio to a minimum (well, did none most of the time bt then upped my sprinting in the summer). Since last week I started doing 10 min HIIT after each of my training sess (a total of 4 a week).

My current training regime;
mon legs wed chest and bi fri back and triceps sat shoulders.

I am a big believer of low rep training so each of my workouts begins with a big compound movement which I hammer for as long as I can, then I might fool around with higher reps and diff exercises. Just to give you an idea: legs: a sumo deadlift 8x3 b1 front squat 3x10 b2 leg press 3x12 c1 bulgarian split squat 3x12 c2 reverse lunges 3x12 d1 leg raises d2 iso obliques hold

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Ok well from what you’ve said I doubt its the training or exercise really. Doesn’t sound like you were overdoing it.

It does sound that the stress of your job and recent high workload with MA could have some significance, but whether it would be enough to drop your levels below the normal range is questionable.

You definitely need the rest of the testing suggested if thats possible. I wouldn’t do anything without that to be honest.

How long would you say you have been noticing symptoms? I’m assuming by the use of supps its been a while?

I would say that when I struggled to sleep for a while I found listening to NLP to unwind immediately before sleep worked well.

I take it from your comments you are still able to have sex etc? Thats a positive for sure.

Its hard to say to do anything really without the rest of the testing as there could be a glaringly simple explanation if your thyroid labs or FSH / LH are way off.

It sounds soft but while waiting for them I’d focus on trying to reduce perceived stress as much as possible. I’ve never meditated but have used NLP - either can work I think.

See friends / girlfriend(s) as much as possible. Ensure you aren’t in work mode 24/7.

Go private if you want but I wouldn’t go to a TRT clinic - you need to see an endo to get investigations into why its low IMO. At our age TRT is likely a foolhardy move.

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Ockey, I am going to reply to your Qs tomorrow, thank you for your input mate, much appreciated.

I just wanted to quickly share my blood results so that you can make sense out of it.
ok, no more speculation on my part, just got the lab results. I had to argue with the nurse who told me that everything was within range… What a joke. Here are the results:

serum testosterone 7.9 10-39
serum FSH 6.2 1-11
serum LH: 4.1 1-8
serum prolactin: 348 0-500
hbAlc level- IFFC standarised 40/mmol/mol 20-42
serum sex hormone binding globin 22 nmol/L 11-71
two other readings were off:
serum urea level levels 8.6 2.5-7.5
ALT 66 3-53
noteworthy mentions:
serum cholesterol 4.5 nmol/L 3-5
serum TSH level 0.93 mu/L 0.3-6
serum sodium 141 nmol/L 136-145
serum potassium 4.1 nmol/L 3.6-5.4
serum ferritin 139 ug/L 30-365

It would seem that the blood work indicates primary hypogonadism with LH and FSH within the range… What do you think?

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Two people have asked you to post body temperatures.

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I’ll check it upon waking tomorrow morning.

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just checked quickly before hitting the sack (11:30 PM GMT): 36.7 �?�°C

This morning I took another reading and it was 35,8
EDIT,I converted the readings into Fahrenheit: 11.30 PM: 98.06 F, 9.30 AM: 96.44 F

Just realised that it was 4 pm when they checked my t levels, would it explain such a low score?

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Ockey, I live with my girlfriend which definitely helps with sex life as there’s no issue of performance anxiety and ED doesn’t seem to affect me. I quit watching porn some 50 days ago and that gave a noticeable boost down south. It is the mental side of things, if you will, that brings me down. I feel like everything is dull and requires too much effort. Not depression type of thing because they are things that I am looking forward that I know I will enjoy, for example I am going to Disneyland Paris tonight with my GF and I am really excited about it.

That said, it’s like somebody just reduced the voltage… Without supps it would be really hard to get carry out day to day activities at a high level. By nature, my job is a stressful one however I have developed some decent coping techniques. There are other worries, inherent to freelancers, such as when am I working next, how to successfully dodge the tax man etc :wink:

KSman, On an unrelated note, TSH is within range but on the low side, do you think it could be the culprit?

Many thanks to everyone who took the time to read this thread.

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TT does not change that much during the day. FT can change quickly.

TSH is good. Please keep checking temperatures and get mid afternoon as well.

Still need fT3, fT4

Your energy levels suggest possible:
-low thyroid hormones and/or iodine deficiency
-adrenal fatigue
-imbalance of neural transmitters, -dopamine

FSH is good, suggesting a degree of primary hypogonadism [weak testicules]. And aches in your testes? In the past when sick or with a fever?

Why would ALT be high? Sore muscles can do that, or drugs.

urea: Are you drinking enough water. When fasting before lab work, you need to keep hydrated.

19

KsMan has hit most of the same notes I was going to.

It’d be useful to see some cortisol tests. AM cortisol should be as close to 700 as possible but its not a particularly diagnostic reading.

Private 24 hour saliva labs may be more useful to you.

TSH is spot on. Your temps looks similar to mine. Get up to just about 98 in the evening but in the mid 96s in the morning on waking. Agree that you really need FT3, FT4 and preferably RT3 (have to test privately for this last one)

I would say that when my Total Testosterone was tested within a week of each other I had an 8am reading at 12.5 and a 2pm reading at 9.0

At least with the LH and FSH readings you can pretty much rule out a problem with your pituitary. Your SHBG looks good also. It would be handy to get E2 tested but I don’t think your symptoms suggest problems with this and you aren’t overweight which also suggests this is not an issue.

I agree that you’d likely have more Test with those FSH and LH readings. Have you noticed any change in size? Swelling? Enlarged veins? Pain as said above?

My endo had mine ultrasounded as a precaution for testicular cancer but were fine. May be something to consider as a long shot.

I’m inclined to lean towards the side of neurotransmitter issue, but you can’t test for that reliably and you can test:

  • 24 hour cortisol
  • RT3
  • Ft3 & Ft4
  • E2
  • B12 / Folate levels

If they come back fine then you have three options as I see it.

  1. Bank on it being a neurotransmitter issue and possibly trial an antidepressant.

  2. Go down the functional medicine route and explore nutrient deficiencies, gut problems etc

  3. Hop on TRT yourself either T or HCG or low dose Clomid. At our age I really wouldn’t suggest this option though before you’d explored the previous two.

Of course its entirely up to you and I’m not a doctor mate, just someone who is going through a similar situation with the NHS and inadequate care.

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B-12/folate: Should be taking a high potency B-complex multi-vit anyways. Suggest skipping costs of testing and buy the vitamins.

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