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Testosterone Replacement Therapy (TRT) Why is it not an option in Ireland

johntoc

So I’ve been doing some research and talking to a few in the know that self medicate with black market testosterone from online sources as they suffer from low testosterone.
Gps in Ireland will not prescribe testosterone for injection as it’s not to treat a virus, cold or flu etc but more for a better quality of life, energy and wellbeing.

But they will give you anti depressants without a second thought if you tell them you feel sad ðŸ˜”

In the US for example testosterone replacement therapy has improved the quality of life for thousands of middle and older aged men.

I for one wouldn’t mind boosting my testosterone levels to that of an18-21 year old once again.

Any thoughts on this??

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TheBoyConor

because declining testosterone in middle and older age is not a medical disorder. It is a normal part of ageing.

GPs will order a T test if they have a genuine concern that you are suffering from hypogonadism. Ie, a level of testosterone that is below the normal range for your age and is causing clinical symptoms.

GPs will not order T tests just for your information for the sake of it without a solid basis for it in terms of symptoms of hypogonadism. One reason is that there is a risk that a patient might use that information inappropriately to self medicate, as you seem to be having ideations about. That is extremely dangerous.

Also the risks of TRT in the absence of clinical hypogonadism outweigh any benefit. The risk of heart attack, stoke and some cancers can increase.

The USA is full of charlatans and maverick "doctors" flaunting their wares with dubious unverifiable claims, questionable trials, paid testimonials and generally ethically borderline promotion and selling practices. Don't believe all you hear from 'murica.

Anyway unless you are suffering from clinical hypogonadism, any perceived benefit you might get from TRT may be largely a placebo effect.

TRT is not going to turn you into a young Cletus Klump like in the Nutty Professorhttps://www.youtube.com/watch?v=_yupC2GiDKo

Keep yourself fit and healthy and observe a healthy diet and exercise well. Good sleep and regular weight training helps to increase testosterone too.

TheBoyConor

Also, GPs and labs have better things to be doing, especially at this time with the Covid crisis, than entertaining some pet TRT project on the whim of a middle aged man with a mid life crisis.

El Gato De Negocios

One of my brothers lives in Dubai and has been having TRT for over 12 months under the supervision of a doctor, he was 31 this year. Reckons its dramatically improved his life in terms of both libido and general feelings of well being.

TheBoyConor

But perhaps he was diagnosed with actual hypogonadism. There is a world of difference between TRT to treat clinical hypogonadism and the sort of "trendy" TRT targetted at those with a mid-life crisis who don't have any clinically significant hormonal deficiencies. there are some individuals who latch on to these "treatments" and become convinced it'll solve their issues, much in the same way that some people become convinced that cosmetic surgery will solve their life issues.

They are two different animals altogether.

I stress again, a modest decline in testosterone with age is a normal part of aging. It is not a medical condition requiring treatment unless it is clinically identified hypogonadism.

Iguarantee

Apologies if it's a zombie thread revival but I wanted to weigh in on the topic as I feel it may be informative for others. I'm going to share my journey in the hope that if there's anyone out there who is suffering, knowingly or unknowingly, from the symptoms of low testosterone that they can gain some perspective and go speak with their primary healthcare practitioner.

To start, I'll say right out that I've been on clinically prescribed testosterone for 6+ years. I'm a critical and analytical person by nature and also in my professional life so I actively sought information at every opportunity during my journey.

What doesn't appear to be apparent to many people is what it takes to get from wherever you are right now to actually being prescribed testosterone, in Ireland. For me, the route was relatively simple (simple, not easy).

I'd spent my all of my teens and early 20's significantly overweight; circa 23 stone @ 6'3" in height. Subsequently, I had lost approx. 9 stone through self-guided diet & exercise. I had utterly transformed my physique and much of my psychology too i.e. I found a new love for exercise and taking care of my body.

I reached my mid-20's and found myself very, very depressed (up to and including suicidal thoughts/ideation). Ultimately, I was diagnosed with depression (I assume that means it was clinical depression) and I was prescribed anti-depressants. I took those for approx. 5 months. I found that they took the highs & lows away but didn't treat the underlying causes (granted they are likely not supposed to do that). I did receive professional help in that regard, though I decided to quit the anti-depressants (cold-turkey) after approx. 5 months, I did not do that with medical guidance, I just felt like it was what I needed to do. that was a personal decision and I don't necessarily recommend that for others.

Around the age of 27 I had been listening to the Joe Rogan podcast and caught an episode where the guest was Dr. Mark Gordon, who specialised in treating US military veterans with traumatic brain injuries (TBI's), low testosterone etc. I do not have a TBI that I'm aware of. However, the podcast spurred me to look at my own symptoms and those of low testosterone, there were so many commonalities that it was like a lightbulb going off in my head. I did further reading and discovered that I had many symptoms of low testosterone; non-existent libido, chronic fatigue/lethargy, depression, mind fog (I actually genuinely have a very strong memory but I had this constant blurry thought process whereby I couldn't think quickly enough). I also had difficulty losing body fat, despite rigorous training and dieting. My sleep was also poor quality. Aside from all this I also realise, in hindsight, that I was over reliant on caffeine (coffee), drinking 6 or 7 cups a day.

I approached my GP and asked for a blood panel for my hormones, primarily testosterone. This is the same GP that had prescribed antidepressants. My GP obliged and off my bloods went for analysis. I can still remember the call, it was a Sunday evening when the GP called me; you've got the testosterone level of a man in his mid-50's (I was around 29 at the time). I believe the normal range is 300-1050 and I sat at about 250 (units of measure were ng/dL I believe). My GP prescribed me testosterone as a topical gel. Each dose is 50mg of testosterone, I would take one dose each day i.e. 350mg per week (I believe this is close to what you're body should produce naturally). I can buy it in almost any pharmacy and it costs about 65 euro for a months supply of Testogel. I apply it to both my upper arms, each morning.

At this remove, I can say that I should have taken more than one blood test to diagnose low testosterone levels. From the research I've done, the standard practice is two or even three tests. I don't know why my GP did not do that. Now, all has ended up well regardless, but for others, I would look at a trend rather than a snapshot of your bloods on a given day. I monitor my bloods three to four times per year to track my health markers (cholesterol, testosterone etc.).

One thing I can categorically say is that your lifestyle is strongly linked to your testosterone levels and how you may feel on any given day. Even though I supplement testosterone I can still eat/sleep (or lack-thereof) myself into feeling like absolute **** if I don't manage my lifestyle. You can out-supplement a ****ty lifestyle.

General practitioners do not deal with testosterone much, in my experience. I would say that it is an obscure branch of medicine in Ireland.

I also went to see a urologist who, upon reading my low testosterone level, simply said "I wouldn't worry about it", suffice it to say that was extremely insulting, given that my symptoms had caused me years of genuine misery. HE was well regarded in his field, but obviously his views on TRT were different.

I subsequently went to see an endocrinologist, he advised that the specific dose of testosterone I was on was appropriate for my symptoms. He also remarked that my medical history and the explanation I gave of my life (e.g. being overweight etc.) was reflected in my blood results and the whole picture made sense and fit together. He did advise that ultimately I should get off testosterone, though he did say that I would like be a person that would be very sensitive to changes in dose, particularly a reduction in the dosage.

So, what are the benefits I've noticed from testosterone supplementation? My overall mood was like a seismic shift, I went from wherever I was to a more upbeat and enthusiastic person, with far more energy for life. My sex-drive and my sex-life were revolutionised. I had a higher capacity for exercise which in turn yielded results such as increased muscle mass and greater fitness (a common misconception is that testosterone makes you jacked, it doesn't, it just allows you to work more and keep the rewards).

I'm unsure how coherent this post is to other users, I'm just writing it as I think of it.

Another thing that's now apparent to me is that your blood results and the whole body is a huge balancing act, one hormones/marker balances another which lowers another, which heightens another. You can't address one blood result without giving it proper context.

========================================================================================

If anyone questions whether they've low testosterone or not, the advice I'd give would go as follows (in no particular order)

*Be self-critical and consider your lifestyle and how it may be affecting your health. Sleep, diet, activity levels, exercise levels, mood, who you hang around with, stress etc. are all factors to consider. e.g. if your sex drive is low, is it because you've low testosterone or because you drink 15 pints every night, eat **** food and sleep 4 hours a night?

*Speak with your doctor, ask their advice and ask for a blood test. Without a blood test you're just speculating. I've read of situations where GP's brush off requests for such tests or point-blank refuse them e.g. "you're 25, you're graaaaand and healthy". Ignore that kind of stuff. You're a patient and you're entitled to an assessment of your bloods if you're paying for the tests (which I did). If refused then I'd go to another doctor. NOTE: That's not the same thing as going to another doctor in order to guarantee you are prescribed testosterone, you may not need it, but getting bloods done is a key step to take. I'd follow up with subsequent blood tests to get a better picture of your health.

*Speak with an endocrinologist; hormones are their speciality and they may have valuable insights that you likely won't get from GPs.

*If you're prescribed testosterone then make sure you stick rigidly to the dosage you're prescribed. Never miss a single dose and don't take more or less than you're prescribed.

I hope I have provided something useful for those reading this. I can only speak for myself so this post is entirely my own views and experience. If anyone has any questions or comments let me know.

Health is wealth!

Vestiapx

If you are born a female and identify as a male you can have as much test as you want, but if you are born a man and want test as you identify as a 30 year old you are looked down on.
I'd be interested in what levels of test a 50 year old trans man is allowed have against a 50 year old cis man.

And please don't take my moaning as criticism of trans men fair fcuks to them in getting what they want. I just feel if cis men want to grow old while maintaining test levels they shod be given the same rights.

justsouthofthenorth

https://www.boards.ie/discussion/comment/116030544#Comment_116030544

Iguarantee, fantastic post, this is very very useful to me. My testosterone just came back as 9.1 on a scale of 7.6 to 31.6 which is very low, age 41. Used LetsGetChecked for the test.

I have seen online clinics and even had an initial phone consultation with one that look promising in terms of actually getting treatment, but they are pretty expensive. Ideally, I would be prescribed testosterone replacement by my GP, but it sounds like it is hit and miss whether that will happen, and that I may be sent on a "wild goose chase" to endrocrinologist, maybe delaying treatment, and maybe not getting it altogether.

I'm thinking I should pursue GP, but keep the online clinic in back pocket just in case GP (HSE) route doesn't work.

Any thoughts?

CreadanLady

The problem with online clinics or blood tests that are done by "specialists" who promote TRT, is that you have no way of knowing if the blood test you are getting is genuine. For all you know, they could be giving you false blood results that show a T deficiency so that they can prescribe you treatment or sell you something.

I'd be very suspicious of anyone that is promoting a certain fix for a certain condition.

Mellor

https://www.boards.ie/discussion/comment/118907461#Comment_118907461

If you results were in range you don't have low testosterone. Congrats you don't have very low test.

Very low test would be outside of the reference range by a long way. You would also need to take a few samples to get an accurate picture. One test is not suitable for a diagnosis.

Iguarantee

I concur that a single blood test isn’t worth basing a decision on.

You can’t draw a line with one point; you need (at least) two points. So get another test to confirm.

Regarding online clinics, I’ve no idea if they provide inflated results. Getting a blood test at your GP is fairly straightforward, it’s the prescription that’s (potentially) the issue, not necessarily the test.

If you have a health concern then address it, don’t wait.

Borderview

Hi all,

I know this is an old thread, if by chance anyone sees this I was wondering how long it takes to see the effects TRT.

I am recovering from testicular cancer and chemo. I have just started TRT, has anyone had similar experiences?

Trondheim

I was in a different situation, but it may give you some insight. I had a tumour that was keeping T artifically low. Tumour was resolved, and T production recovered by itself. I felt the effects (return of libido) within a few weeks. I had a follow up appointment with the consultant endocrinologist, and i was able to guess before he told me the results of the bloods that T had returned to normal levels.

Borderview

https://www.boards.ie/discussion/comment/121761976#Comment_121761976

Thank for your reply. Hopefully I will have a similar experience

Trondheim

https://www.boards.ie/discussion/comment/121790071#Comment_121790071

Best of luck. I can only imagine how difficult it is to go through what you have experienced. Hopefully you'll see good results with the TRT.

For me, the reduction in T had happened incrementally over a long period of time. In the end, i had no libido, but it had reduced over such a long period of time, i had forgotten what it felt like to have those urges. I remember watching a movie about a guy who refrained from orgasm for 40 days and 40 nights. He was going around with a constant erection. I thought it was completely made up, and couldn't believe that people really cared about sex. When the tumour was addressed, and libido came back, i was like "oh, i remember this!".

population

I've often wondered why the ranges are so vast. At the minimum amount, a level of 300 ng/dl seems like a very low bar. Like what are the clinical reasons for it not to be say 500ng/dl? The upper end is 1000, so why not say half that amount is the acceptable minimum?

Vestiapx

Women can have hrt

Women who want to be men can have testosterone treatment

Men who's test levels have dropped due to age can't have test even though ut will .ake them happier ?

WhWhy

Trondheim

Health risks.

There are side-effects to artificially increasing your testosterone levels.

Trondheim

https://www.boards.ie/discussion/comment/122556711#Comment_122556711

See here:

https://en.wikipedia.org/wiki/Reference_ranges_for_blood_tests

Scroll down for "Usual or Optimal"

Anthony A

Ive bad low T for years had many tests for it and diagnosed by a doctor from tests also but so far I've refused the TRT treatment as I'm only 31 and it's such a big commitment. I always hoped I'd have children but I have such chronic health issues that's its looking less and less likely, the effect of TRT on fertility would be my main concern. I was told freezing my sperm was one option but I just felt it seemed too a big decision at this age.

Now though I have hypertension and chronic fatigue that's upending my life, I've had plenty of tests and nothing is showing up bar blood pressure and some kidney issues related to it. I've been through the psychiatric route before got off medications and it's not the answer for me although still do some therapy. My life right now is misery daily though and I'm about to lose my job from being ill. I've got no real answers from GP tests.

I suppose it's coming to the stage where I'd have nothing left to lose by rolling the dice with TRT. Even if I have something like Chronic fatigue there is no diagnostic tests, treatment or help there it seems. I guess I just think the testosterone was a symptom of something else but I've never fixed that whether it's the gut or immune system etc

Just wonder what would others do in my situation? I'm hovering around 200-350 max Ng/dl for at least the past 4 years minimum but I suspect this may be the case for me going back to teenage years.

Trondheim

https://www.boards.ie/discussion/comment/122679456#Comment_122679456

I presume you are dealing with an endocrinologist and not just your GP? If not, you should look for a referral to an endocrinologist. If you are not getting good support from your existing endocrinologist, you should look for a second opinion.

There are specific treatments that can boost testosterone and sperm production (e.g., Clomid). Your endocrinologist should be able to advise on all of these matters.

If your T is low, you will suffer with lots of adverse effects.

Get good medical advice and get it sorted.