Suspected low T - advice on speaking to GP


New member
Hey guys.

How's it going? First post here. Been lurking for a few days and was hoping for some advice.

I'm 35 and have had a low sex drive and general lack of energy for a good few years now. I always put it down to a stressful job, poor sleeping/eating habits, poor fitness, etc, never seemed a real mystery to me.

However, about five years back I started lifting again, cleaned up my diet, and got into fairly good shape. I also changed career and I love my job now. However, I still have this 'walking through treacle' feeling that I've had for a long time and I just can't understand why. I have to really force myself to do housework etc and can't be arsed with a lot of my old hobbies. I also realised how bad my libido was recently. Having been single for a few years, I hadn't had to perform spontaneously so assumed that all was ok, mainly because everything functioned ok when I did feel horny. However, in Feb I started dating a girl from work and on three separate occasions I had to make excuses to get out of sleeping with her because I wasn't turned on. It wasn't lack of function, it was more lack of interest, despite finding her really attractive when I'm in the mood.

I had the same thing happen a couple of years back and I told myself it was stress. I decided to sort my job, house move etc before starting dating again and tbh I'd probably still be telling myself that had the most recent one not asked me for a drink.

I only started considering low T to be a possibility a few weeks back when I was looking online to find out why I often wake up with a drenched tshirt even when it's not particularly hot - one of the first symptoms was low T.

Went to see my doctor today and despite having read that the NHS can be a mixed bag, I decided that I'd initially be as open minded as possible as it could be many things causing it. However, I'm a bit sceptical after my visit. I told him that I'd been putting this visit off for ages and had low energy and terrible sex drive, told him about my recent bad experience, said I had no real reason to be depressed outside of these issues. His response was that 'you don't need a reason to be depressed' and when I asked if it could be hormonal because I'd read that night sweats were a symptom, he pulled up my recent blood test (from Oct before I moved to new area/doctor) and said everything good and my liver was 'ok'. I asked if it was worth also testing for low testosterone as I had originally thought it would be done in the original blood test, and he looked at me and said word for word "you're a big chap and with that beard I can say with certainty it's unlikely to be a problem, but I'll test it to rule out the possibility.'

I'm happy that he's prepared to test it but surely he can't jump to conclusions by just looking at me! I'm trying not to jump to any conclusion myself but I'm a bit scared that if they come back at the bottom of the 'normal scale' then he'll try and give me an antidepressant instead. I've read that the NHS guide range doesn't account well for age and that you can be less than half of the average for your age group and be told you're ok despite exhibiting symptoms.

What do you guys reckon?

He lists his areas of interest as 'diabetes, heart disease and mental health.'
I just got prescribed test injections by my gp for my low t levels. I was apprehensive about asking for the blood work even though I had ordered my own through private me and knew it would come back low. The conversation went great with my doctor. I think it helped that I came across as informed and not sounding eager. im just trying to decide it I want to commit to life long trt at 34.
Cheers for replying man.

Would you mind if I asked what your levels were? PM me if you prefer.

I tried not to come across to eager. I mean, after all I could still be on the totally wrong track and my test levels may be fine. But if they're sub optimal I don't want to be fobbed off. I've read stories about guys with real low levels whose docs refused treatment etc.
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Cheers for replying man.

Would you mind if I asked what your levels were? PM me if you prefer.

I tried not to come across to eager. I mean, after all I could still be on the totally wrong track and my test levels may be fine. But if they're sub optimal I don't want to be fobbed off. I've read stories about guys with real low levels whose docs refused treatment etc.

GP Doctors generally 'treat' diseases or medical conditions (they are trained to 'stop the bleeding', sort of speak). Being 'sub-optimal' however is NOT a medical condition, and that's why you probably won't be treated for that; unless your working with a 'vitality clinic' or wellness doctor.
My blood test is scheduled for 2:40pm on Monday. From what I've read it should be tested first thing in the morning usually...
I would see if you can reschedule or just show up at 8am and pretend there was a miscommunication. OP's doctor not scheduling you at 8am means he either doesnt know what he is doing, or has no intentions of treating you for low t. Which puts your chances of getting on injections pretty low IMHO but I hope I'm wrong.

The body makes testosterone at night when a person sleeps, so the best time to test for it is right away when a person wakes up. If it is not right away in the morning it is easier to explain away or dismiss borderline results. Or later he could get referred to another doctor who will see the test wasnt done at 8am and dismiss the results. Ive had it happen to me. My draws were at 9am and 930am and the last "specialist" i saw said they were taken too late. Even if a person wakes up at noon every day they will still want an 8am draw for testosterone.

OP might have a good enough relationship with his doctor that it might not matter and if he is hypogonadal he might get treatment for it.
did you try a restart bro? clomid 25/25/25/25 nolvadex 20/20/20/20. people also use 12.5 mg clomid every 5 days for 4-5 months for restart.

if i were you i would try 12.5 clomid + 10 mg nolvadex every day for 2 months. high doses comes with side effects.
Cheers for the replies guys. Think I'm just gonna go to the 2:40 appt and see what my levels come back as. If they are below where they should be then taking the test later in the day may put me in a better position to argue my case - i.e. lower readings.

If they're pretty low but he says they're fine then I'll have to think about the next step.
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Ok, had my test now. Going to just use it as a rough indication. If it's low enough to warrant treatment I may just consider going private and possibly come back to the NHS in a year or so when I've found what works and can get a letter from private doc expounding the positive effects of my treatment.

My doc seems to have already decided that I don't have low t on the basis of my having a beard and he seems keen to go down the depression route although I don't feel depressed!

Odds are that if I did score particularly low and could get him to prescribe TRT, he would still probably only want to get me above 8 or 12 at the most from what I've read. I'd rather fork out just to get my life back on track tbh if it comes to that stage.
Should have my results in next day or two. Had a few questions...

- From your experience, will my GP likely be happy to give me a printout of my blood results? Will this raise suspicions? If I decide to go private it could save me a few hundred if I already have a recent blood panel. I've read that I can do an 'access request' or something like that to my doctors but it can take up to 30 days if I go down that route. I don't really want to pay £350 extra for the sake of a week or two.

- What do I say if he continues down the depression route? I just don't buy this. I'm happy with my life in general. It's just this lack of sex drive/motivation that's got me down. Even when I lost my best friend of 20 years in a car accident a few years back I still had a much greater libido. And I really hated my job at the time. I don't believe it's the cause as I've changed careers a while back and I'm generally less stressed than I've been before. It's just that the symptoms are so similar.

- If it comes back low should I still consider going private? The NHS may be happy to get me into the very bottom of the range, and then I've also read a lot about how I should take HCG or an aromatose inhibitor which are things I could probably obtain more easily going private.
Unfortunately, I don't know UK law, but I do know in the US they HAVE TO give you a printout if requested.

Ahhh, the good old, "let's blame it on everything BUT hypogonadism" tactic. I went through that crap for ten years, taking drugs for depression, anxiety, restless leg syndrome, and drugs to counter the sides of those drugs.

NONE of those will help if you're hypogonadal. In fact, they can make things worse in those that truly do not NEED them. I had facial hair, a full head of hair, and a demeanor that didn't scream "I have low T!" - yet, I came back with blood results lower than a teenage girl.

Don't let them persuade you from getting to the bottom of this. I did for many years, and it has cost me dearly in health issues that I've been slowly fixing over the last six. YOU are the boss, and are in charge. I realize that NHS makes it more difficult, but the fact remains that it's your body - and your decision.

Private may be the way to go if you're subclinical, but I hope it doesn't have to come to that as it can be quite expensive.

My .02c :)
The symptoms that BigStu81 gives are common to both low testosterone and depression.

It doesn't hurt to get testosterone levels checked, in fact I've heard a recommendation that it's done if a patient is depressed and suffering from erectile dysfunction or loss of libido.

I'd have suggested getting free testosterone checked too. Low levels are strongly correlated with depression and also the sexual side effects of SSRIs. If you think that your libido is bad now, I found a 100 mg dose of Zoloft shut me down almost completely.

Testosterone levels don't vary so much during the day in older men. I'm not sure when the cycle changes, but I think it's in your thirties. So a 2:40 pm blood draw might not be such a problem.

Lastly, I've heard anecdotes of people using steroid clinics as a way of getting their testosterone levels checked in the UK even if they're not taking any PEDs. They tend to be run by charities, are free at the point of use, but I don't know if there are any near where you are.
Got a call from the nurse today.

Testosterone results not back but she said everything was ok aside slightly elevated liver function - possibly the result of drinking 4-5 pints the day before at my mate's birthday.

She said that the reference ranges are provided by the lab and that if they were borderline then they would look at the symptoms and reach a decision that way. This sounds good in principle as long as the lab are working to the guidelines of >400 rather than >270 which I've also seen - not sure which is more likely (anyone?). 35yo and fairly active (but a tiny bit overweight) what would be an acceptable test score?

P.s. They're happy to give me a printout too, which is good.
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Ok, results are in...

Serum testosterone level (XE2dr): 10.7 nmol/L (reference range 7 - 27)

Serum 17-alphahydroxyprogesterone level (XaERC): 2.6 nmol/L (reference range 1.2 - 5.0)

Serum androstenedione level (XE2pn): 2.3 nmol/L (reference range 1.1 - 4.7)

Follow up action: No Further Action
Been doing some research online and a bit pissed off now tbh!

- Read an NHS guidelines website which said that <8nmol was likely to be hypergonadism but that anybody within 8-12nmol who is exhibiting symptoms could also be a candidate for TRT and should be retested, especially if young.

- Elite Men's Guide states "normal testosterone levels generally range between 300 ng/dL and 1050 ng/dL" putting me at the very bottom of the range and presumably this covers all ages. The studies they publish all put me at half the average for my age and also half that of people ten years older than me.

- states that the threshold for decreased frequency of morning erections is 11nmol and the threshold for reduced vigor is 13nmol.

- Quote from Art of Manliness states "I had below average testosterone level. My total testosterone was 383 ng/dL, which is near the bottom of the reference range of the lab I used." (Admittedly 'below average' isn't always a problem).

- also confirms the average to be 679, confirming I have half of that.

This is just what I've found in ten mins. So it seems I am in the treatable range. Part of me feels like I should print off the pct guidelines document and take it back to him - am assuming the more 'macho' websites would probs not be as persuasive. However, I also feel like it would be a potentially frustrating journey even if I did try from what I've read.

I appreciate that it would be fairly easy to get a referral to somebody else but I've also read a lot of bad things about endos being just as bad and only treating people under 279nmol etc - although I've also read of people who got lucky with great endos. Another issue is that I'd be unlikely to get an aromatose inhibitor on the NHS and would only get HCG if actively trying to conceive. I'd rather not self prescribe just yet and wouldn't want to risk being denied/stopped treatment due to self medicating some elements.

Will probs book myself an appt with a private doc and go from there. As I'm sitting the treatable range (and have a copy of my test to keep hold of) I may be able to go back to the NHS once I've established a suitable treatment protocol and argue "I didn't realise I was eligible as my doctor said I was outside the NHS range." Preferably with a letter from my private doc. The thought of getting a prescription (if that's the best course of action) in several weeks is much more appealing than months of f*cking around.

I was talking to the girl from work today that I was dating and she was flirting like crazy but I just couldn't bring myself to risk getting into another embarrassing situation! She thinks that I was just stressed from new role at work etc, but if I continued to make excuses she might think I'm impotent. Hell, that's not something I want her sharing with all my other workmates (mainly female and mostly her friends as she's worked there seven years). If I was able to get myself back to former energy levels in next few months then maybe just maybe there is a chance it could have a happy ending. My doctor said he would be prepared to look into whether I'm depressed, and when I said I don't think so and if so only because of this, he said that some people just have low sex drives. F*ck that! I used to be much randier in my 20s and won't accept that no arousal with a naked girl in my bed who I find attractive is a normal thing at 35yo!

Anyway, rant over. What do you guys think?
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