What happens when you have low testosterone
BOM reader Dan White on his experience with low T and how treatment changed his life - eventually.
So here we go again; it’s 5am and I need to get up to go to work. The problem is that my eyes are so heavy it appears as though someone has glued them shut in the night. I can barely open them and my body aches in places I didn’t know existed previously. Actually sitting up is physically beyond me. It’s all I can do to rock myself back and forth in order to gather enough momentum to just roll out of bed. This momentous task achieved, I drag my weak and weary body down the hall to the bathroom where I make the mistake of looking at myself in the mirror. I look like I feel which is best described as a used tea bag. I’m out of shape despite having exercised my entire life and my eyes are so badly sunken into my head it feels like I’m staring out through them from somewhere at the back of my skull. I have the libido roughly equivalent to a five day old corpse which in fairness I don’t mind as I wouldn’t have the energy anyway and any kind of physical exertion on my part feels like it may have fatal consequences. All of this is of course quite normal. As us men grow older our bodies slow down and weaken. After a while there’s a very real danger of being hospitalised by a good sneeze. If you’re lucky perhaps you may just get away with peeing yourself a little, which is way preferable to a slipped disc. As I say all of this is par for the course and part of nature’s great plan to return us to the earth. The problem for me is that I’m 35 years old.
So how did this happen? And more importantly what did I do about it?
In short I was going through a genuinely horrible divorce (not one of those fun ones) having made a fatal error by emigrating halfway across the world to Canada with someone whose main goal in life, it appeared, was to destroy me. It’s fair to say that I barely survived the years I spent living in fear of my own wife, the mother of my two young daughters. Needless to say, the fallout from an abusive marriage was a predictably abusive divorce complete with false allegations of every kind cast against me (all unfounded and unproven) and never ending Family Law Court appearances which despite me seemingly ‘winning’ every time, made no actual difference to my quality of life or stopped my ex-wife making my existence away from her a far bigger nightmare than it ever was when we were together. What I thought was me breaking free from the chains that she had shackled me with and getting control of my life back so as I could enjoy being a father to my two wonderful, perfect young daughters only succeeded in opening the floodgates to hell. I would in no uncertain terms go on to realise that my old married life which had left me at that time with genuine thoughts of killing myself as my only means of escape was in fact a utopia compared to what she would do to me following my unforgivable defection to the normal world.
So there I was, 4000 miles from home and the nearest effective babysitter, working full time in an unforgiving job with unsociable hours with 50/50 custody of my girls one week on one week off. The custody issue I had fought tooth and nail for through the courts and being there for my girls was the only thing I actually cared about. Numerous horrified onlookers pointed out that it was impossible to pull that all off. There were not enough hours in the day, not enough support structures, not enough money, not enough guardian angels to make it work. And they were right of course. But when you are a proud, loving father to your daughters, you make it work. You make it work through the unbearable stress, through the complete lack of sleep, through ducking work as much as possible without actually getting caught and losing your job and you do it for years. You do it for years against all the odds and against everyone’s expectations. But the problem is with all this pressure and stress is that eventually something has to give or something will break. In my case I refused to give and so something broke. What broke was me.
It started slowly of course with feelings of exhaustion but who wouldn’t be exhausted going through this? It would be impossible not to surely? Over time I noticed my work outs had become worse and worse to the point I couldn’t remember the days where I had used to look forward to them and was actually getting some kind of physical benefit. Instead now I was merely going through the motions in the gym. I found I couldn’t get up in the mornings or for that matter off the bloody sofa. Cooking became way too much hassle along with trying to keep the house clean and tidy and as my body began to creak and ache under the strain of merely standing I thought to myself I feel like I’m 70. I actually became scared of falling over in the street because I knew my body wouldn’t be able to take it and just to remind you I was until then a fit and healthy 35 year old. I couldn’t push a swing more than three times. Could barely lift the girls up to the monkey bars. If I took them ice skating I would shamelessly grab their skating aids (think of a Zimmer frame on ice) and would grip the handles as if my life depended on it, which frankly it may well have done at that point.
Eventually enough time passed and after trying to sleep better, to not drink and to eat healthily all with absolutely no effect whatsoever, I lay in bed one day feeling like my body weighed three tons and finally thought to myself I’m bloody sick. The second thought that came into my mind was I’ve got no testosterone. I think I’ve started the male menopause.
I made an appointment at the local surgery and dragged myself along a week later to be met with the usual state doctor, meaning someone who couldn’t have been less interested in my survival unless he’d actually caught me shagging his mother. As I described my symptoms, specifically stating that I felt like I had no testosterone in my body, he listened wearily as only a doctor can. I’m quite certain a good portion of their training is dedicated to perfecting the ability to look at someone while somehow telepathically communicating to them that you think they are lying and you don’t intend to help them in any way. He begrudgingly agreed to a blood test and so a couple of weeks later this 35 going on 70 year old dragged himself back down to the surgery.
I was met by the same disinterested doctor who informed me that my testosterone wasn’t low enough to prescribe me anything but he did in his infinite generosity and spirit of goodwill do me the immeasurable favour of giving me a prescription for vitamin D tablets. Vitamin D!!!! I was 35 and could barely open my eyes but don’t worry, all would be fine. I had a Vitamin D prescription! Magic. And with that I shuffled off home.
I left the surgery knowing that I had just somehow been deeply and badly shafted. Nonetheless I dutifully went to the nearest pharmacy to take possession of something as likely to fix the way I was feeling as a kick in the gonads. Needless to say it made absolutely no difference. Odd that.
So life went on. Day to day I was feeling like an aging geriatric, groaning when I stood up and shambling around, too tired to play with my lovely daughters and gradually accepting that maybe this is how you are supposed to feel in your mid-thirties. Otherwise surely the doctor would have helped, right?
The breakthrough came about six slow, painful months later when describing my symptoms to a work colleague who immediately announced you got low testosterone, man. I told him I had been given a prescription of bugger off tablets and his advice was not to waste time on the government doctors. He had had a similar experience before going private and had never looked back. I made the appointment at a surgery down the street from my house and unsurprisingly the experience was indescribably different. The doctor on this occasion actually sat and listened to my backstory (during which she was visibly upset. You always know you’re a proper sad case loser when this happens). She had even got hold of my previous blood test that led to me being prescribed some miracle working Vitamin D to cure my woes. Unlike the previous doctor however she went through the results with me. There was only one that actually had a big red ‘L’ next to it signifying it was low. Spoiler alert: it wasn’t my sodding vitamin D. There right before my sunken eyes was six month old proof that I was right about how I felt. My testosterone was low and nothing else. This doctor was so outraged at my previous treatment she recommended I report the other GP to the Medical Association but I just didn’t have the energy though I probably would have summoned up the strength to punch him on his disinterested nose. The effort would surely make me keel over but I would have enjoyed it immensely. As I type this six years later in fact I still feel genuine bitterness toward him for not giving a crap.
My new private physician on the other hand prescribed me testosterone immediately. The effect was likewise near immediate. After years of feeling like garbage, I felt alive again. I had back clarity in my thoughts and felt alert for the first time in years. Not like a twenty year old, just like a fit and healthy person in their mid-thirties. Which is all I wanted!
There is massive stigma and ignorance around testosterone and some doctors are convinced men only want it to go to the gym and bulk up. That viewpoint is painfully ignorant and the fact so many people subscribe to it is embarrassing and without doubt causing many men to be denied medication they genuinely need.
The truth is a tiny amount of testosterone injected into the lifeless corpse of someone who is low in it has no more effect then making that person/corpse feel slightly more human again. Nothing more. These doctors who are convinced a three weekly millimetres of Sustanon is going to transform someone from an Egyptian Mummy to the Incredible Hulk should really receive some basic training on the subject.
Low testosterone can affect anyone but in my case it was brought on by years of stress caused by an abusive relationship and the fallout from it. My body was essentially stuck in fight or flight mode. The problem with fight or flight mode is that during it your knackers cease testosterone production. Now that’s absolutely fine when running away from an elephant for example but a problem occurs if the elephant continues to chase you for several years without relent at which point you end up with no testosterone and you can be sure at some point, as a result of this a trampling is coming your way.
Testosterone Replacement Therapy (TRT) is no short term fix. Once on the medication (and it is medication not Arnold Schwarzenegger juice) most men remain on it. It is not a cure but it is a remedy to an increasingly common problem which more men should be educated about. This education is very unlikely to come from your GP as they look to save money in any way they can, with men’s physical health certainly not at the top of their list of priorities in the NHS.
I found this out to my expense (both physical and financial) when I was able to immigrate back to the UK in 2016. By this point I had been being prescribed testosterone for well over a year in Canada. I couldn’t wait to come home and the only thing I was remotely concerned about was that I might somehow have an issue getting hold of any in the UK. Courtesy of the NHS my concerns were predictably realised.
This was my first mistake – I used the NHS. I love the NHS and in the unfortunate event of me being trampled for example by the aforementioned elephant chasing me I know that as long as I am stretchered into the A&E in a very near death state, I will receive truly unbeatable world class health care. Where the NHS falls down however is when you make the mistake of walking in under your own steam to ask for help. The logic appears to be if you are well enough to get yourself in there you can’t be that bad so p**s off (at least that is the most sophisticated way that I can describe it).
So I threw myself upon the considerable lack of mercy of my local GP. After explaining my sad backstory and actually showing her my current and I may add last vial of testosterone from Canada she helpfully pointed out that I looked pretty healthy thereby entirely missing the point. She then begrudgingly provided me with a referral letter for the correct clinic, which of course was nowhere geographically near me. The cherry on top was contained within one of the paragraphs of the referral letter which warned that young men use testosterone for the purposes of weight lifting. Thus I left my first five minute appointment with the NHS in 5 years feeling suitably unsupported and humiliated.
Needless to say the short answer here is several months later having taken sufficient time off work to make the appropriate appointments in the place nowhere near me I was again told that while I was low, I wasn’t low enough to meet the NHS prescription level. I had after all walked into the office under my own steam, hadn’t I?
The fact about testosterone levels is that there is no correct level. Each individual is completely different to the next and required levels cannot be generalised. One person may naturally have a much higher level than the next and it’s possible that a single dad going through hell and working full time may need slightly more than a retired 70 year old… Who am I to know such things, of course?
Refusing to allow myself to return to feeling like a zombie after so much hard work or to let my humiliating experience with the NHS (which hilariously I seemed to be paying about £300 into every month in National Insurance contributions) to deter me, I again went down the private option. Because I was working in Central London and needed every spare second to look after the girls I chose a clinic near my place of work. Once again the experience was the polar opposite of my NHS appointment. I saw the doctor within a couple of days and given that I provided him with all my previous paperwork and blood tests from Canada (just as I had done to the NHS of course) I was literally given a testosterone injection there and then on the spot before even receiving the results of my blood test. Oh to be trusted! It goes without saying that when my blood test did come back (later that same day I may add) it again justified my need for a boost proving the doctor absolutely correct in supplying me with it without the need to wait or even throw in some demeaning comments about weight lifting first.
The boost felt great as my Canadian prescription had run out by this time. This was actually a different type of testosterone to the one commonly supplied in Canada but it had the same effect. It’s hard to describe the relief you feel inside yourself just to know you are going to feel normal again. Normal doesn’t sound like much of an aspiration until you’ve been asked to stand aside and let a WW2 veteran walk past you in the street because you’re holding them up. At that moment, trust me, you will yearn for a little injection of normal.
Over the next few months I returned to the clinic every three weeks for another dose and would get excited every time knowing that I was going to continue to feel human for another few weeks. The only problem however was the recurring cost. Each injection was about £300 plus consultation with the doctor and regular blood tests and the cost was moving swiftly into the thousands, which frankly I just couldn’t afford.
I took the next best option and moved down to the gel that you rub into your arms. This was about £100 a month, not including consultations etc. but was a few hundred a month cheaper which I needed to save. Let me be clear; I could have saved an extra £100 a month and had just as much benefit had I chosen to rub olive oil into my skin. In fact the olive oil would probably be better as it would have moisturised me at least. The gel has little to no effect whatsoever and could not possibly be absorbed into the system in the same way as a deep intra-muscular injection can. So after a couple more months of that I stopped using the gel and decided to try living without testosterone. I couldn’t afford the effective treatment through the clinic and the gel was pointless and I certainly was far too fit and healthy apparently to be assisted by the NHS. Curse my ability to stand unaided.
So again the months passed as my body began to creak and slow, as my eyes began to sink back into my head as my broken body continued to churn out testosterone at a rate which would not meet the needs a three year old.
Only by luck about a year later did a chance conversation turn things around. I discovered that there are different kinds of private GPs. Nothing to do with the NHS but also not priced anywhere near as high at the high end ‘Wellness’ clinic that I had managed to blindly select in Central London. I did my research with genuine excitement and found a Private GP surgery just ten minutes from my house. The receptionist was helpful and informative and told me the cost involved up front. To give an example the same Nebido injection that was £700 at the Central London Clinic was £130 here. For the exact same thing! Suddenly I found I could actually afford to get the help I needed.
I waited impatiently for the whole three days before I could get an appointment (my local GP practice currently has a three week backlog of appointments which is a long time to wait before being told to bog off). Once again I enjoyed the experience of sitting with a doctor who was listening, interested and clearly willing to help rather than judging and scoffing at the idea a man of my relatively young years could possibly be unwell. A blood test was taken and the results returned the same day and I was back two days later to receive my first injection. Finally I had access to reasonably priced testosterone albeit three years after returning to the UK. It’s tough to describe the relief of knowing that I now have some certainty that can only come with having the right GP and access to the right medication at the right price. Knowing that as I sit here now at the age of 40, I actually feel 40. Not 60, not 70. Not the size of Dwayne Johnson. No big veins the size of courgettes throbbing out of my neck as the NHS feared. Just a normal in shape 40 year old with the energy to work, live, love and look after his amazing children with the fondness and enthusiasm they deserve.
So what’s my point here? It is simply that if you are a man, regardless of age and circumstance, if you feel like absolute garbage even though you have tried to live cleanly and well and have previously been a healthy, active individual, you may have low testosterone levels. Get yourself checked out! But just remember if you have had the strength to read this article in full you are already likely way above any level the NHS will consider assisting you. I’m quite sure they could take a sample from Tutankhamun before announcing no, not low enough after short deliberation. Find a local private GP near you and discuss costs with them. Don’t get fleeced by an unaffordable wellness clinic. You will know the difference because one will charge about £40 to see the doctor the other will charge nearer £400. Get a blood test taken which again costs very little and get yourself well. Low testosterone is a common problem in men and one that as with most male health problems it is not discussed openly or not taken seriously by public health care. Remember, you know your own body better than anybody else. Don’t be fobbed off with Vitamin D prescriptions or let your head go down with patronising references to weight lifting. Other people’s ignorance is exactly that – other people’s. Read up and educate yourself and if you think you need help, do yourself and everyone around you a favour and go and get it. If you do it right it needn’t cost the earth and remember, any investment in yourself is one worth making.
Remember you’re worth it.
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