FAQ’s Testosterone Deficiency

Before your consultation, it is necessary to complete two sets of blood tests, a detailed blood test and a separate testosterone-only test.
Detailed Blood Test must include:

• Full blood count
• Testosterone
• Liver function tests
• LH (luteinizing hormone)
• FSH (follicle-stimulating hormone)
• SHBG (sex hormone-binding globulin)
• Oestradiol
• Prolactin
• Lipid profile
• PSA (prostate-specific antigen) if you are over 40 years old
• Ferritin

You have two options for arranging these tests:

1) Requesting your GP to conduct the tests on the NHS, although this is subject to your GP’s discretion. Approximately half of GPs are willing to arrange these tests through the NHS for private healthcare purposes.

2) Alternatively, you can choose to have the tests done privately. We recommend Medichecks (medichecks.com). The Medichecks Advanced TRT test includes all the required tests mentioned above. Use the code LEGER10 during checkout for a 10% discount. There are also other private blood companies you may wish to also look at to provide the required blood tests.
Testosterone Test Only

For the testosterone only test, in addition to the detailed blood test, it is crucial to schedule this test either one month before or after the detailed blood tests. This timeframe allows for capturing relevant changes in testosterone levels, which fluctuate throughout the day and over time, aiding an accurate diagnosis. Please note this must be a venous test, a finger prick test is not suitable for this purpose. Medichecks offer a testosterone-only test, please ensure that you order the venous version of the test.

If you have any questions, please contact enquiries@legerclinic.co.uk

Good question. Access to a renowned team of specialist Testosterone Doctors and Advanced Nurse Practitioners who and who regularly attend British, European and World meetings ensuring you get the best medical advice, with up to the minute information and care from Clinicians who can immediately implement new treatments, thinking and medication.

i. Providing private prescriptions for you to get dispensed at a pharmacy of your choice so saving you a great deal of money as this will enable you to shop round on price. Please note that Leger Clinic does not sell the medications directly to you meaning that the clinic does not “mark-up” the cost of your prescription. Your prescription may also be uploaded to one of the online pharmacies we work with and this will be if the medication is cheaper from them or is not available from high street pharmacies

ii.Responding to your email queries, any side effects queries, commenting on your blood results and general progress with your treatment.

iii. With your permission, writing to your GP asking if they will do your monitoring blood tests and if they are prepared to prescribe for you on the recommendation of the Leger Clinic Doctors.

This is a slightly more complex area. As a part of this fee, we will write to your GP and ask them if they will support you in doing the appropriate blood tests and even ask them if they will consider prescribing. About half of all GP’s will support these blood test. However, you need to be aware that if they will not assist you will need to get blood tests done privately with a company such as Medichecks.

You would need the Medichecks Advanced TRT blood test @ £149. There is a link to Medichecks on the Leger Clinic website and you will receive a 10% discount if you book a test via the website.  You could also ask your GP if they would be willing to do them, in which case you would need to advise them to test the following:  SHBG, LH, FSH. Prolactin, Testosterone and full blood count

https://www.medichecks.com and enter LEGER10 at the checkout page to get 10% discount. 

Please make sure that bloods are taken before 11am in the morning.

Please do not exercise prior to having bloods taken.

Please note that typically you would then need bloods again after about a month on treatment, then 3 months, then 6 months, then subsequently every 6 months but this would only need to be testosterone, oestradiol and full blood count (Medichecks Sports Hormone Blood Test – £109) and then twice yearly you would additionally need cholesterol. If you are a man over 50 (45 if you are at higher risk, we will advise you about this during your consultation), additionally you need a PSA blood test twice a year.

Once you are on testosterone treatment, if this is by injection, you should get “trough” levels i.e. in the 48 hour period BEFORE  an injection is due NOT in the 48 hours post injection. If you are on gel treatment, the blood test should be 2 – 4 hours after the gel has been applied.

The fee for initial consultations is £242 effective from 1st July 2023.

You will have a telephone consultation with one of the specialist Doctors at the Clinic. The Consultation generally lasts about 45 minutes on the phone and includes a detailed history, taking an AMS questionnaire. Blood tests will need forwarding prior to consultation to enquiries@legerclinic.co.uk There will be plenty of time for you to ask questions during this telephone Consultation. We will also explain and we will discuss the various treatment options.  For this reason, we do not require detailed emails prior to your consultation. Equally in the first year you will be reviewed either by email or phone at 3 months, 6 months and 12 months minimum this will give you plenty of opportunity to discuss any issues and concerns with us. We find that patients do not really need to be in touch with us apart from at these review periods.

No, the Leger Clinic offers a full range of appropriate treatments including: Chlomiphene, Gels and injections including the use of HCG when appropriate. These will all be discussed in detail at your Consultation.

Yes, as and when appropriate.

Uniquely for Testosterone Clinics, one of the doctors will issue you with a private prescription. This means you can shop round for the pharmacy which will offer the best price. SAVING YOU A GREAT DEAL OF MONEY Your prescription may also be uploaded to one of the online pharmacies we work with and this will be if the medication is cheaper from them or is not available from high street pharmacies

Dr Benjamin Davis discusses whether an increased risk of prostate cancer is one of the risks of taking testosterone replacement therapy. 

There is no convincing evidence that an increased risk of prostate cancer is one of the risks of taking testosterone replacement therapy. However, an absence of evidence doesn’t totally rule out the risk of prostate cancer after starting testosterone. To be on the safe side, for men over the age of 50, checking your prostate through examination and monitoring of your PSA is recommended before starting testosterone replacement therapy and with a repeat PSA test at 3 – 6 and 12 months, and yearly after that. 

Yes, apart from improving you sexually there are a number of benefits which are now beginning to emerge from men who have been taking TRT long term. Among these are:

• Improvements to your cardiovascular system
• Improvements to your cognitive function and memory
• Increased mineral bone density to help prevent fractures.
• Increased muscle mass and decreased body fat

All that said it is a mistake to expect miracles. The benefits from TRT are often subtle and mild and TAKE TIME!

Not necessarily life transforming but rather life enhancing.

Surprisingly, this is where there is such disagreement which leads generally to the diagnosis of TDS being missed. Traditionally, and, the level given out by many NHS laboratories, gives a level of under 8 as being abnormal.

There are now several guidelines European Society of Sexual Medicine, the International Society of Sexual Medicine, The European Society of Urologists and even our own British Society of Sexual Medicine which state that levels of testosterone under 12 warrant a trial of testosterone therapy if the Doctor seeing the patient has a high suspicion that the patient has the condition.

In 2015 a group of leading world Andrologists produced the following statement:

“1. Symptomatic men with total testosterone levels lower than 12 nmol/l should be treated with Testosterone therapy.

2. A trial of testosterone therapy in symptomatic men with total testosterone levels of higher than 12 nmol/l can be considered based upon clinical presentation”

i.e. if a Testosterone specialist such as myself or one of the medical team feels that the clinical picture fits with testosterone deficiency, then a trial is justified

Most experts agree that a patient should also have a calculated free testosterone which is done by measuring the SHBG in addition to testosterone.

Your first port of all could be your GP who may assist you with the appropriate tests, or alternatively, The Leger Clinic Ltd has negotiated with Medichecks, the country’s leading private blood testing laboratory for a 10% discount for all Leger Clinic patients requiring a blood test for checking their testosterone levels along with other relevant tests such as Thyroid function.

To access this discount all you need to do is follow this link:

https://www.medichecks.com and enter LEGER10 at the checkout page to get 10% discount. 

You would need the Medichecks Advanced TRT blood test @ £149. There is a link to Medichecks on the Leger Clinic website and you will receive a 10% discount if you book a test via the website.  You could also ask your GP if they would be willing to do them, in which case you would need to advise them to test the following:  SHBG, LH, FSH. Prolactin, Testosterone and full blood count

Please make sure that bloods are taken before 11am in the morning.

Please note that typically you would then need bloods again about a month after your start testosterone treatment, then 3 months, then 6 months and then subsequently every 6 months but this would only need to be testosterone oestradiol and full blood count )Medichecks Sports Hormone Blood Test – £99) and then twice yearly you would additionally need cholesterol. If you are a man over 50 (45 if you are at high risk and this would be discussed in your consultation), additionally you need a PSA blood test twice a year.

Once you are on testosterone treatment, if this is by injection you should always get “trough” levels i.e. in the 48 hour period BEFORE an injection is due NOT in the 48 hours post injection. If you are on gel treatment the blood test should be 2 – 4 hours after the gel has been applied.

If testosterone is used on its own it will markedly reduce fertility. Therefore in patients where fertility is a key issue/concern we would prescribe either Clomifene tablets or more frequently chose to add HCG injections (Gonasi) to their testosterone treatment and to a large degree this will protect their fertility.