Testosterone Replacement Therapy Consultations

Testosterone Optimisation Gives You The Foundations Necessary To Achieve Your Full Potential

 

TRT Consultations

Let Us Support You In Your Journey To Achieving Optimal Hormonal Balance And Stability


 

Testosterone Deficiency

Testosterone Deficiency or Male Hypogonadism is a recognised medical condition. There are three types:

  • Primary Hypogonadism – Where you have an issue with your testes.
  • Secondary Hypogonadism – Where you have an issue with your hypothalamus and/or pituitary.
  • Tertiary Hypogonadism – Where you have an issue with Prolactin causing a secondary picture.
  • Mixed Hypogonadism – Where there is not predominantly primary, secondary, nor tertiary in origin.

It is important to establish a diagnosis so that not only can a possible reversible cause be identified, but also so that your personalised management protocol can be tailored to you.

Testosterone levels decline with age.  This serves a biological function, making way for future generations. Low testosterone however, is bad for your health.  Optimising your testosterone levels decreases your susceptibility to chronic diseases.

In this modern ‘civilised’ world we are living longer, but are we living better? Advances in modern medicine have had an impact on both our quality and quantity of life.  It is a rather peculiar situation to ignore optimising hormonal balance, when it serves as one of the core fundamentals in sustained health.

The impact of this modern life and living environment on testosterone levels is not to be ignored.  Average testosterone levels are dropping at an alarming rate as we become more civilised. Our DNA hasn’t changed, so the decline can only be attributed to our lifestyles.

 

Common Symptoms

In our clinic, the commonest presenting symptoms of low testosterone include:-

  • Loss of libido and/or erectile dysfunction.  The likely NHS solution?  A little blue pill.
  • Low mood, anxiety, depersonalisation.  The likely NHS solution?  Antidepressants.

Our patients have often resisted this and sought out the actual diagnosis – LOW TESTOSTERONE.

Other symptoms include:-

  • ‘Brain fog’, loss of motivation and drive.
  • Fatigue, loss of strength, poor recovery after exercise.
  • Weight gain and increased visceral fat distribution.

Symptoms can also include night sweats, increased insulin resistance and loss of bone mineral density (osteoporosis).

Our patients often confess to not feeling like their old selves anymore, and are desperate to feel ‘normal’ again.  Testosterone Replacement Therapy (TRT) isn’t about making you super-human, it’s about restoring you to your former self.  It’s about giving you the ability to take that leap over the invisible barrier that exists when your testosterone level is low.

 

Treatment

Our preferred treatment option is a single ester testosterone, such as Testosterone Cypionate or Testosterone Enanthate, alongside Human Chorionic Gonadotropin (HCG).  The single short-acting ester attached to the testosterone makes controlling both testosterone and oestradiol levels easier as there is a linear increase with an increase in dose.  We do not use Sustanon, a blend of four esters, as the likely peaks and troughs often mean an aromatase inhibitor is needed to control oestrogen.  Why complicate matters with artificial chemicals that can have a negative impact?  Surely, it’s better to finely titrate your levels according to your genetics and physiology?  The perceived intensive injection frequency necessary to achieve stable male androgen levels using Testosterone Cypionate or Enanthate may not suit everyone, so we do offer alternate testosterone preparations, outlined on the page You TRT Options.

We believe Human Chorionic Gonadotropin to be a fundamental component to restoring hormonal balance, as it mimics Lutenising Hormone (LH).  Not only is it important for retaining fertility and testicular size, there are LH receptors in the brain that convey a qualitative improvement compared to testosterone only TRT protocols.  HCG also up-regulates other hormones in the cascade down from Pregnenolone.  We consider TRT to be Hormone Replacement Therapy.

 

Our Philosophy

Optimising your testosterone level at our TRT clinic isn’t about chasing numbers, its actually about you and how you feel, rather than a quantitive number. Dr Stevens, our specialist TRT doctor, will work with you to help you find that perfect TRT protocol for your individual needs. It’s about relinquishing a little control in order to gain it back, it’s about placing your trust in your TRT Doctor. Let us be the doctor and you be the patient. We want Testosterone Replacement Therapy to be routine, we don’t want it to consume you because it really doesn’t need to. We want you to get on with living your life!

 

Our Patients

We are very proud of what a positive impact The Men’s Health Clinic has had on our patients’ well-being. I think our testimonials and the continued growth of our clinic speaks volumes. It’s about changing the philosophy of testosterone optimisation, it’s about increasing understanding and awareness, it’s about applying common sense to attaining and sustaining health.

Let us help you be you again.

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New Patient TRT Consultation

(60 Minutes)

Your initial appointment involves a face-to-face consultation with your clinician where he can review your symptoms, conduct a thorough physical examination and assess your overall suitability for Testosterone Replacement Therapy.

This will include a review of what symptoms and signs are of most importance to you, and whether or not these are likely to be attributable to low testosterone, or potentially another cause that may also need to be addressed.  A review of the quantitative and qualitative screening questionnaires issued prior to your appointment act as a good starting point for you to identify what matters most to you.

It is important to look at your past medical history, current/past significant conditions, illnesses and operations that may be influencing your current state of health.  An in-depth look at current and past medication usage may give an indication of what is going on, and whether alterations to these may influence the decisions we make in your care.

Your social history is also taken into consideration, including any past drug usage, as this can often provide a useful insight into your current testosterone level. The information you give is in complete confidence so the more information you give us, the more we can potentially assist you.

Your bloods will then be taken to look at the quantitative blood markers necessary for initiating Testosterone Replacement Therapy.  This would be either the ‘TRT Complete’ or ‘TRT Complete Plus’ blood panel (detailed below).  Both tests give us a comprehensive analysis of your blood, so that a diagnosis can be made and other possible causes excluded.  If this is the first diagnostic blood test you’ve had to assess your hormonal status, you would need a SECOND confirmatory Total Testosterone test, ideally four weeks later, to confirm the diagnosis.  If you have had previous blood tests and/or investigations carried out, please bring hard copies of these with you so that they can be taken into consideration.

At the end of your consultation you will have the opportunity to use our InBody 770 medical grade bioelectrical impedance scanner.  This allows us to record and track data relating to your physical health, as well as providing you with a benchmark to work from.  Repeat scanning would also form part of your annual face to face follow up consultations.

 

Consultation Fee:  £280 + Blood Tests

Book Your Appointment

 

 

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Commence Treatment Consultation

(30 Minutes)

At this consultation your clinician will review your blood results with you and commence treatment as agreed.  Where appropriate this will include going over safe preparation of your medications and, if you will be self-injecting, gently guiding you through safe and correct injection technique so that you leave the consultation room with confidence, ready to embark on your journey.

We are always happy to support you in approaching your GP to have your ongoing blood tests and medications organised under the NHS where possible. A letter requesting shared-care with your GP can be issued at the end of your consultation if required.

 

Consultation Fee:  £160 + Medication

Book Your Appointment

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New Patient TRT Consultation

(90 Minutes)

This is essentially both the 60-minute ‘New Patient’ consultation and 30-minute ‘Commence Treatment’ consultations detailed above, combined into one extended appointment.

This is suitable for patients already on TRT, who are wishing to transfer their care from the NHS or another private clinic or provider.  If you are transferring your care over to us, you will need to bring along your original diagnostic blood test results and/or clinical correspondence confirming your deficiency to your appointment.  If you do not have up to date blood results, we can organise them for you prior to your appointment, or they can be taken during your consultation.  Both the ‘TRT Complete’ or ‘TRT Complete Plus’ blood panels are suitable options (detailed below).

This 90-minute consultation may also be suitable for patients living much further afield, for whom two successive visits to clinic would be impractical.  In this instance, you will need to already have confirmed testosterone deficiency, as demonstrated by two separate diagnostic blood tests.

At the end of your consultation you will have the opportunity to use our InBody 770 medical grade bioelectrical impedance scanner.  This allows us to record and track data relating to your physical health, as well as providing you with a benchmark to work from.  Repeat scanning will also form part of your annual face to face follow up consultations.

We are always happy to support you in approaching your GP to have your ongoing blood tests and medications organised under the NHS where possible. A letter requesting shared-care with your GP can be issued at the end of your consultation if required.

 

Consultation Fee:  £420 + Medication

Book Your Appointment

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Telephone Consultation

(15 Minutes)

Four weeks after starting treatment you will need to organise having your bloods drawn to see how your body is responding to therapy.  You will also need to schedule a telephone consultation with your clinician at around five weeks (to allow enough time to receive your results back from the lab) to discuss how therapy is going and for any adjustments to be made to your starting protocol if necessary.

Telephone consultations can also be booked between routine follow-ups if you wish to discuss your treatment plan with your clinician over the phone, rather than via email.

 

Consultation Fee:  £50

Book Your Appointment

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Follow Up TRT Consultation

Clinic / Skype

(30 Minutes)

Your next follow up consultation is usually eleven weeks after commencing treatment.  For this follow up you have the option of coming into clinic and having your bloods drawn as part of the consultation or, if more convenient, you may have this consultation conducted via Skype after you’ve already had your bloods taken at 10 weeks.

This consultation will be an opportunity to discuss your well-being and any side effects that you may be experiencing.  Your clinician will correlate this information with your blood results to see where your hormone levels are now that you are stable.  Your standard three month medications/prescriptions will also be issued at, or following, this appointment.

You will then be followed up just once every six months, with up to date blood results.  Again, your clinician will review your current protocol, discuss any health concerns that you might have and formulate an on-going action plan so that we can continue to safely and effectively prescribe your TRT.

PLEASE NOTE – All patients MUST have a face to face consultation in clinic at least once every 12 months, so that a physical examination can be carried out as appropriate.  This is non-negotiable as it promotes safe and effective practice. 

Once every 12 months you would also have another opportunity to use our InBody 770 body composition scanner so that we can continue to track and record data relating to your on-going physical health.

 

Consultation Fee:  £160 + Blood Tests

Book Your Appointment

Standard Blood Test Options

 

TRT Complete PLUS:  £159

This gold standard blood test encompasses all of the necessary blood investigations required to make a formal diagnosis of testosterone deficiency.  It also includes additional parameters to help identify any potential reversible causes of low testosterone, including vitamin deficiencies, and gives you a more complete picture of your general health.

Test Includes:

  • Total Testosterone
  • Free Testosterone
  • Prolactin
  • Oestradiol
  • Follicle Stimulating Hormone
  • Lutenising Hormone
  • Full Blood Count
  • Prostate Specific Antigen
  • Urea & Electrolytes
  • Liver Function Tests
  • Sex Hormone Binding Globulin
  • Ferritin
  • HbA1C
  • Lipids, including Cholesterol
  • Thyroid Function Tests
  • Folate
  • Zinc
  • Vitamin B12
  • Vitamin D
Special Instructions:
  • If you are NOT on Testosterone Replacement Therapy, this diagnostic test should be performed fasted (from midnight the night before your appointment), between 07:00-11:00, and not during an episode of acute illness.
  • If you ARE on Testosterone Replacement Therapy, it does not need to be a fasted or morning sample, but you should avoid administering your medication/s that day until AFTER your blood test.
  • Please ensure that you drink plenty of water prior to your blood test.
  • For an accurate PSA result, you should NOT have an active urinary infection, ejaculated or exercised heavily in the last 48 hours; had a prostate biopsy in the last 6 weeks or had a DRE (digital rectal examination) in the last week.

 

TRT Complete:  £119

This comprehensive blood test encompasses all of the investigations required to make a preliminary diagnosis of testosterone deficiency.  It also looks at other health parameters to help identify any potential reversible causes of low testosterone, and gives you a more complete picture of your general health.

Test Includes:

  • Total Testosterone
  • Free Testosterone
  • Prolactin
  • Oestradiol
  • Follicle Stimulating Hormone
  • Lutenising Hormone
  • Full Blood Count
  • Prostate Specific Antigen
  • Urea & Electrolytes
  • Liver Function Tests
  • Sex Hormone Binding Globulin
  • Ferritin
  • HbA1C
  • Lipids, including Cholesterol
  • Thyroid Function Tests
Special Instructions:
  • If you are NOT on Testosterone Replacement Therapy, this diagnostic test should be performed fasted (from midnight the night before your appointment), between 07:00-11:00, and not during an episode of acute illness.
  • If you ARE on Testosterone Replacement Therapy, it does not need to be a fasted or morning sample, but you should avoid administering your medication/s that day until AFTER your blood test.
  • Please ensure that you drink plenty of water prior to your blood test.
  • For an accurate PSA result, you should NOT have an active urinary infection, ejaculated or exercised heavily in the last 48 hours; had a prostate biopsy in the last 6 weeks or had a DRE (digital rectal examination) in the last week.

 

TRT Review:  £99

This blood test includes all of the necessary blood investigations for routine monitoring whilst on testosterone replacement therapy, so that you and your clinician can be confident that your treatment is continuing to be prescribed safely and effectively.

Test Includes:

  • Total Testosterone
  • Free Testosterone
  • Prolactin
  • Oestradiol
  • Full Blood Count
  • Prostate Specific Antigen
  • Sex Hormone Binding Globulin
Special Instructions:
  • You should not administer your TRT medication/s until AFTER your blood test.
  • Please ensure that you drink plenty of water prior to your blood test.
  • For an accurate PSA result, you should NOT have an active urinary infection, ejaculated or exercised heavily in the last 48 hours; had a prostate biopsy in the last 6 weeks or had a DRE (digital rectal examination) in the last week.

 

TRT Protocol:  £69

This test identifies what physiological effect your recent TRT protocol change has had on your most important hormone levels. Dr Stevens will take these into consideration alongside your current symptoms.

Test Includes:

  • Total Testosterone
  • Free Testosterone
  • Prolactin
  • Oestradiol
  • Sex Hormone Binding Globulin
Special Instructions:
  • You should not administer your TRT medication/s until AFTER your blood test.
  • Please ensure that you drink plenty of water prior to your blood test.

Additional Blood Test Options

 

PSA:  £49

This blood test measures the amount of Prostate Specific Antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It is normal to have a small amount of PSA in your blood, and the amount rises slightly as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but this does not necessarily mean cancer.  All abnormal results should be discussed with your doctor.

Special Instructions:
  • You should NOT have an active urinary infection, ejaculated or exercised heavily in the last 48 hours; had a prostate biopsy in the last 6 weeks or had a DRE (digital rectal examination) in the last week.

 

DHT:  £89

Dihydrotestosterone (DHT) is one of your bioavailable male androgens.  Testosterone is converted to DHT by the enzyme 5-alpha reductase which is located in the testes and prostate.  DHT has effects on brain function (including libido), muscle growth and repair, and prostate health.

Special Instructions:
  • If you are NOT on Testosterone Replacement Therapy, this diagnostic test should be performed fasted (from midnight the night before your appointment), between 07:00-11:00, and not during an episode of acute illness.
  • If you ARE on Testosterone Replacement Therapy, it does not need to be a fasted or morning sample, but you should avoid administering your medication/s that day until AFTER your blood test.

 

DHEA-S:  £39

Dehydroepiandrosterone (DHEA) is a hormone produced from cholesterol by the adrenal glands, which your body converts into testosterone and oestrogen. It affects many areas of health and wellbeing.  Most of the DHEA in the body exists in the blood in the sulphated form, DHEA-S, which is what this test measures.

Special Instructions:
  • Do not take biotin supplements for 2 days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

Pregnenolone:  £179

Pregnenolone is a chemical substance produced in your body from cholesterol, and is a precursor to all steroid hormones. This test measures the amount of pregnenolone in the blood.

Special Instructions:
  • None

 

IGF-1:  £109

Insulin-Like Growth Factor 1 (IGF-1) is a hormone which helps to control how rapidly the body’s cells grow and reproduce. IGF-1 blood tests are used to diagnose growth abnormalities and to evaluate pituitary function.

Special Instructions:
  • Do not take biotin supplements for 2 days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

Progesterone:  £39

Pregnenolone is considered the father hormone, with Progesterone being one of the important hormones involved in that pathway to testosterone, cortisol and aldosterone.  Healthy levels are necessary for sleep and stress reduction.

Special Instructions:
  • Do not take biotin supplements for 2 days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

Serum Cortisol:  £49

Cortisol plays a role in metabolism and is the main hormone involved in stress and the fight-or-flight response.  Disorders of the adrenal glands can cause the over or underproduction of stress hormones which can cause symptoms such as excessive fatigue, anxiety, insomnia and weight gain.  This test measures whether your cortisol production levels are too high or too low, which could be having a negative impact on your sense of well-being.

Special Instructions:
  • Please take your sample as soon as possible after waking. Your result could be affected by corticosteroid medication (e.g. prednisolone). Ask your doctor whether you should stop before testing.  Do not take biotin supplements for 2 days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

TFT – Standard:  £39

Thyroid Function Tests include:

  • Thyroid Stimulating Hormone (TSH)
  • Free T3
  • Free Thyroxine (T4)
Special Instructions:
  • Sample must be taken in the morning.
  • If you are taking a medication containing T3, do not take your usual dose until AFTER the test.
  • Do not take biotin supplements for two days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

TFT – Complete:  £59

Thyroid Function Tests include:

  • Thyroid Stimulating Hormone (TSH)
  • Free T3
  • Free Thyroxine (T4)
  • Thyroglobulin Antibodies
  • Thyroid Peroxidase Antibodies
Special Instructions:
  • Sample must be taken in the morning.
  • If you are taking a medication containing T3, do not take your usual dose until AFTER the test.
  • Do not take biotin supplements for two days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

 

TFT – Plus:  £119

Thyroid Function Tests include:

  • Thyroid Stimulating Hormone (TSH)
  • Free T3
  • Free Thyroxine (T4)
  • Reverse T3
Special Instructions:
  • Sample must be taken in the morning.
  • If you are taking a medication containing T3, do not take your usual dose until AFTER the test.
  • Do not take biotin supplements for two days prior to this test. If you are taking prescribed biotin you should discuss this with your doctor.

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