Testosterone Testing on the NHS

We’ve recently run a series on UK centric TRT and testosterone testing articles, and the most obvious question which always comes up in relation to this is;

You’ve worked hard, paid your taxes – you deserve to know your test levels, right?

Well … it’s not as simple as that unfortunately. If you live in the UK and take even a passing interest in the news and current affairs you’ll know that the NHS is under sever financial pressure. With health spending in England alone expected to be £124 billion in 2017/2018 and predicted £30 billion funding gap by 2020, it’s fair to say GPs are not going to be readily spending money on unnecessary testing.

Which begs the obvious question … is testing your testosterone levels necessary?

Do you have symptoms of ‘Low T’?

The NHS are clearly making efforts to head off requests for testosterone tests, and testosterone replacement therapy.

‘Low T’ is a massive industry in the US, which is fair enough as they pay for their own healthcare there. The NHS clearly doesn’t want it to be a massive industry here, with them footing the ever growing bill.

I Googled ‘Getting testosterone tested on the NHS’ and got the results below;

Sitting in at number 1 is the official NHS PR piece aimed at killing off any ideas that it will treat anything other hydogonadism with Testosterone Replacement Therapy. It should be entitled;

“By golly we’re British – pull your socks up man, remember the spirit of The Blitz”

From the Horse’s Mouth

OK, so what have the NHS got to say about the symptoms of low testosterone?. Well they start by listing a number them;

1. Depression
2. Loss of sex drive and erectile dysfunction
3. Mood swings and irritability
4. Loss of muscle mass and reduced ability to exercise
5. Fat redistribution, such as developing a large belly or “man boobs” (gynaecomastia)
6. A general lack of enthusiasm or energy
7. Difficulty sleeping (insomnia) or increased tiredness
8. Poor concentration and short-term memory

They then go on to acknowledge that testosterone levels drop by 2% a year from the age of 30-40. But the thrust of their article is to try and debunk the media created invention of the ‘male menopause’, and that the symptoms mentioned above are nothing to do with testosterone at all.

Their stance is that, other than those with clinical late-onset hypogonadism (which they describe as “an uncommon and specific medical condition”), all of these symptoms can be explained by personal issues and lifestyle choices. Including stress, depression, anxiety, relationship issues, divorces, money problems, and having old parents.

Most insultingly, if none of those problems seem to fit then they suggest that you are having a midlife crisis. After realising how little you’ve accomplished and how meaningless your life is. Seriously, if you don’t believe me then read it.

According to them, the cure is simple. More sleep, better food, improved diet, more exercise, drink less, stop smoking. And for God’s Sake man, start feeling better about yourself, your low self esteem will be the death of you!

NHS Treatment: By The Book

As far as the NHS policy is concerned, it’s not your testosterone unless you present with clear symptoms of full blown hypogonadism.

Your initial assessment will involve a discussion about your work and personal life, with your GP trying to determine if you have any mental health issues, stress or anxiety.

The following list are presenting in their policy document as potential treatments for those;

Cognitive behavioural therapy, self-help, talking therapies, antidepressants, paying more attention to the present moment, using calming breathing exercises, download some relaxation apps on to your phone, listen to an anxiety control audio guide, meditation, self-help groups.

Your Doctor

Your GP MAY order a blood test to get your testosterone levels clarified. If the test results come back showing that you do indeed have clinically low testosterone levels then the next step would be a referral to an endocrinologist.

So as with most things it depends on your doc. He or she will have discretion to order a blood test if they think it necessary.

However …. based on the guidelines produced by the British Society for Sexual Medicine;

“The initial assessment of all men with erectile dysfunction and/or diminished libido should therefore include determination of serum testosterone.”

So of all the symptoms mentioned at the start of this article, the ones most likely to result in a testosterone test should be the ones relating to libido and erectile dysfunction.

It should be noted, the BSSM guidelines also state;

“Common symptoms of Late Onset hypogonadism include fatigue, reduced well-being, depression, loss of concentration, hotflushes and sweats, reduced muscle mass and weakness and reduced body hair.”

Which takes us full circle back to our initial list of symptoms.

Other Interested Parties

Further down the same Google results shown earlier were results from bodybuilding forums, with guys talking about gaming the NHS system to get their testosterone tested for free so they could manage their steroid cycles;

With users not only telling porkie pies about their erectile dysfunction to get tested in the first place, but going one step further and managing their steroid cycles so that their natural testosterone production was at it’s lowest when they were tested by the doctors or endocrinologists. Thereby getting free courses of TRT courtesy of John Q Taxpayer.

These were from 2011 and 2013 though, I’d suggest the days of doctors happily arranging testosterone tests for recreational drug users to be a thing of the past. Which is a good thing, that’s the kind of thing The Sun should be bleating about, not older guys with Low T. A lot of lying and deceit just to get a blood test.

Conclusion

If that all sounded like an awful lot of hassle to establish whether or not you have low test levels, then you and I share the same opinion.

Yes it is possible to get a blood test on the NHS to establish your test levels.

Let’s break it down. For a start, in the case of most inundated doctor’s surgeries, if you didn’t have stress and breathing difficulties before trying to get an appointment of any sort, you probably will afterwards.

It is likely to result in hours out of your working day, possibly more than once. It is likely not to be an easy process. You don’t know exactly what they’ll test for (Total Test, Free Test, SHBG), a you have no control over it.

Depending how much your time or sanity is worth, it may be a lot easier to just pay for a home test. They are done in a Laboratory and start at about £40.