Male TRT - blood test - Bangkok

[MarkyM3]

Hi, 

 

Could anyone recommend a clinic or similar where I could go to get a blood test to check for testosterone, E2 (Estradiol) and perhaps a few more TRT indicators and a rough idea of what that might cost?

 

I've been on TRT in the UK for a while and had to change my protocol shortly before I came to Thailand at beginning of year from Nebido injections to Tostran (aka Fortesta) gel. Not been feeling good at all lately (libido is terrible) and I don't return to UK for another 2+ months and don't really want to wait until I get back to be checked.

 

My reason for wanting to check E2 is I have been using anastrozole (Arimidex) as an AI inhibitor but not sure if I'm underusing or overusing this now with the gel, given how I feel. It's powerful stuff and unfortunately the symptoms of going too far either way are apparently pretty similar ????

 

TIA

Edited May 1, 2022 by MarkyM3

[FriendlyFarang]

This clinic has prices on their website, they are in Chiang Mai, but the prices across clinics are similar, so it gives you an idea: https://www.cmflabchiangmai.com/th/products

 

You could look for "N Health" on Google, they also have a branch in Bangkok (Never been there, have only been to their branch in CM), you can just contact them through Facebook, they won't provide a price list overview, but if you ask "how much for E2?" they will tell you their price.

[greg71]

https://www.pathlab.co.th/our-services/. I myself am on trt  (test e ) / hcg protocol  libido is great . Nebido stay away from id say . Also adding 5mg cialis per day does wonders for the sex drive .Personally id stay away from any Ai  Staying active and being able to sleep plays a big role in how you feel. 

[Hummin]

In my opinion the most professional lab and clinic in Thailand. You pay for it, but not so much different comparing to Bangkok Hospital anti aging clinic Bangkok. 
 

Max have clinic in Pattaya and Bangkok

 

http://www.maximumclinic.com

[greg71]

Just now, Hummin said:

In my opinion the most professional lab and clinic in Thailand. You pay for it, but not so much different comparing to Bangkok Hospital anti aging clinic Bangkok. 
 

Max have clinic in Pattaya and Bangkok

 

http://www.maximumclinic.com

I think they charge 9000 baht for the blood tests , which you can get done your self at a lab for about 3000 baht tops 

[MarkyM3]

20 minutes ago, greg71 said:

https://www.pathlab.co.th/our-services/. I myself am on trt  (test e ) / hcg protocol  libido is great . Nebido stay away from id say . Also adding 5mg cialis per day does wonders for the sex drive .Personally id stay away from any Ai  Staying active and being able to sleep plays a big role in how you feel. 

Thanks Greg.

 

HCG doesn't tend to get prescribed as an adjunctive to T by UK doctors working in public health (which is where my treatment has been done). Typical protocol is either T + an AI if desired (and provided you have an reasonable endo - plenty are not) or HCG + AI if you explicitly want kids. I suspect that hasn't helped and I plan to see a private doctor specialising in this when I return to the UK and I'll pay for a private prescription for HCG.

 

Been on various treatments for 3 years (Nebido, various gels) and not been happy with any of them. Also worried about testicular atrophy/sperm count due to the lack of HCG...might already to be too late in that dept given the time on TRT. 

 

I've tried Cialis (and Viagra) and it does work OK for me but I get side effects from them. They didn't boost my libido particularly imo, just helped downstairs but I've found the effect has worn somewhat, with Cialis at least, over time. 

 

I got good figures on Nebido but didn't really prove to be effective in reality imo. I find gels a total pain though and they aren't that good for my skin either.  

Edited May 1, 2022 by MarkyM3

[FriendlyFarang]

7 minutes ago, MarkyM3 said:

HCG doesn't tend to get prescribed by UK doctors working in public health (which is where my treatment has been done) as an adjunctive.

Afaik the only reason to use HCG when on TRT is so that your testicles don't stop working and you stay fertile. If you don't plan to have a baby in the next time there is no reason to use HCG.

Unless of course there is another use of which I'm not aware, then please enlighten me.

[greg71]

6 minutes ago, MarkyM3 said:

Thanks Greg.

 

HCG doesn't tend to get prescribed by UK doctors working in public health (which is where my treatment has been done) as an adjunctive. Typical protocol is either T + an AI if desired (and provided you have a reasonable endo) or HCG + AI if you explicitly want kids. I suspect that hasn't helped and I plan to see a private doctor specialising in this when I return to the UK and I'll pay for a private prescription for HCG.

 

Been on various treatments for 3 years (Nebido, various gels) and not been happy with any of them. Also worried about testicular atrophy due to the lack of HCG. 

 

I've tried Cialis (and Viagra) and it does work OK but I get side effects from them. They didn't boost my libido particularly imo, just helped downstairs but I've found the effect has worn somewhat, with Cialis at least, over time. 

 

I got good figures on Nebido but didn't really prove to be effective imo. I find gels a total pain though and they aren't that good for the skin either.  

Check this facebook group out , has a lot of members and doctors who actually care about optimizing your hormone levels . you be able to ask for a doctor in the UK who will look after you https://www.facebook.com/groups/670172930008544

[Hummin]

14 minutes ago, greg71 said:

I think they charge 9000 baht for the blood tests , which you can get done your self at a lab for about 3000 baht tops 

I know you do not get the whole panel they do for 3k, but each and one for itself. They do a proper wide panel test, and also have a dr who see the whole picture and not one test by itself. 
 

 

[MarkyM3]

1 minute ago, FriendlyFarang said:

Afaik the only reason to use HCG when on TRT is so that your testicles don't stop working and you stay fertile. If you don't plan to have a baby in the next time there is no reason to use HCG.

Unless of course there is another use of which I'm not aware, then please enlighten me.

I am 51 now but may want kids still. So that's my main reason. Also, my balls have shrunk on this regime and I've seen a noticeable reduction in semen quantity though whether that's linked to it or not I don't know. I'd also like to know whether it has had an effect on my libido or not. 

[Hummin]

13 minutes ago, MarkyM3 said:

I am 51 now but may want kids still. So that's my main reason. Also, my balls have shrunk on this regime and I've seen a noticeable reduction in semen quantity though whether that's linked to it or not I don't know. I'd also like to know whether it has had an effect on my libido or not. 

Nebido killed my balls, and not good for my mood at all. I now have best stable T by using 125 mg Bayer Enenthate pr week. Ideal would be every 8 - 9 day, but easier with every week same day to administer. If Im on travel one 250 every 2 weeks. 

I do have good results with gel to, and have no problem with libido, when using gel for a few months. 

Edited May 1, 2022 by Hummin

[Hummin]

BTW My dr at Max do not recomend anastrozole (Arimidex) at all, since if normal function on Estradiol, it follows T proportionally. 
 

Anastrole is a strong medicine you have to be careful with, and one bloodtest will not say much really

 

 

What is the Role of Estradiol in Men?

Many men assume that estradiol is simply “bad”. They think that because estradiol is one of the primary female hormones and because high levels may cause gynecomastia and/or edema, estradiol should be reduced as much as possible. However, this is not true.

While high levels cause certain side effects in genetically susceptible, estradiol plays many important roles in men. For example, it plays an important role in determining bone mineral density in men. Low levels may well be the major cause of bone loss in elderly men.

Low estradiol levels are associated with increased fat and decreased sexual desire and erectile function compared to higher levels

 

https://www.vantageurology.com/posts/low-testosterone-low-t/anastrozole-arimidex-for-men-on-testosterone-therapy/

Edited May 1, 2022 by Hummin

[MarkyM3]

6 minutes ago, Hummin said:

Nebido killed my balls, and not good for my mood at all. I now have best stable T by using 125 mg Bayer Enenthate pr week. Ideal would be every 8 - 9 day, but easier with every week same day to administer. If Im on travel one 250 every 2 weeks. http://www.maximumclinic.com

I do have good results with gel to, and have no problem with libido, when using gel for a few months. 

Which gel did you use? I'm on Tostran (Fortesta) again but unfortunately I'm having a worse experience than with Nebido, though I don't know if that's due to the AI (I have stopped used Anastrazole for last 12 days to see what happens but nothing positive, hence why I wanted to see if my E2 is out of whack here). 

[MarkyM3]

9 minutes ago, Hummin said:

BTW My dr at Max do not recomend anastrozole (Arimidex) at all, since if normal function on Estradiol, it follows T proportionally. 
 

Anastrole is a strong medicine you have to be careful with, and one bloodtest will notvsay much really

 

 

What is the Role of Estradiol in Men?

Many men assume that estradiol is simply “bad”. They think that because estradiol is one of the primary female hormones and because high levels may cause gynecomastia and/or edema, estradiol should be reduced as much as possible. However, this is not true.

While high levels cause certain side effects in genetically susceptible, estradiol plays many important roles in men. For example, it plays an important role in determining bone mineral density in men. Low levels may well be the major cause of bone loss in elderly men.

Low estradiol levels are associated with increased fat and decreased sexual desire and erectile function compared to higher levels

 

https://www.vantageurology.com/posts/low-testosterone-low-t/anastrozole-arimidex-for-men-on-testosterone-therapy/

Yep, I read up a lot on it. I'd rather not use it but found my E2 levels went high on both gels and Nebido if left unattended. A key problem is I seem to be very sensitive to it and a bit too much either way affects my readings a lot. Probably one reason why TRT has not been going well for me.

 

Feel like I'm stuck between a rock and a hard place rn! 

 

Btw...I'm currently getting 3mg of T (6 pumps of Tostran) daily. That's the recommended dose. My last Nebido injection was November 2021 so that should be out of my system now. 

Edited May 1, 2022 by MarkyM3

[Hummin]

7 minutes ago, MarkyM3 said:

Which gel did you use? I'm on Tostran (Fortesta) again but unfortunately I'm having a worse experience than with Nebido, though I don't know if that's due to the AI (I have stopped used Anastrazole for last 12 days to see what happens but nothing positive, hence why I wanted to see if my E2 is out of whack here). 

Androgel 50mg Im using 
 

I tried anastrole 0.25mg every 3 days, but even that I got to low E. How much did you take? 
 

I always experience higher libido at the end of my cycle before new injection when take 250mg enenthate, and my dr says that is normal, but when taking 125mg a week, it is rock on steady as I was 35 year again. 
 

 

[MarkyM3]

1 minute ago, Hummin said:

Androgel 50mg Im using 
 

I tried anastrole 0.25mg every 3 days, but even that I got to low E. How much did you take? 
 

I always experience higher libido at the end of my cycle before new injection when take 250mg enenthate, and my dr says that is normal, but when taking 125mg a week, it is rock on steady as I was 35 year again. 
 

 

With Nebido, I was doing 0.25mg pf Anastrozole twice one week, then one 0.25mg on the other week. Any more got me too low over time. But.... I could also seem to go the other way and get E2 readings over the recommended max which made it so hard dialling in Anastrozole on Nebido (I requested full blood tests before every injection, despite complaints from doctor/endo...).

 

With the symptoms of high or low E2 being similar to some degree, it really makes it hard to know what's going on without a test.  

 

I switched back to Tostran after using it briefly in the past and I'm somewhat regretting it rn, given how I feel. I'm not sure what is going on with my T and E2 levels without a test. I can get my blood panels done free in the UK but I won't return there for over 2 months so would like some figures now. Fed up of <deleted> libido and it sure isn't helping my relationship with gf here, that's for sure.   

 

 

[Hummin]

8 minutes ago, MarkyM3 said:

With Nebido, I was doing 0.25mg pf Anastrozole twice one week, then one 0.25mg on the other week. Any more got me too low over time. But.... I could also seem to go the other way and get E2 readings over the recommended max which made it so hard dialling in Anastrozole on Nebido (I requested full blood tests before every injection, despite complaints from doctor/endo...).

 

With the symptoms of high or low E2 being similar to some degree, it really makes it hard to know what's going on without a test.  

 

I switched back to Tostran after using it briefly in the past and I'm somewhat regretting it rn, given how I feel. I'm not sure what is going on with my T and E2 levels without a test. I can get my blood panels done free in the UK but I won't return there for over 2 months so would like some figures now. Fed up of <deleted> libido and it sure isn't helping my relationship with gf here, that's for sure.   

 

 

I can recomend Max clinics, since they know more about it than normal dr’s and been totally worth it for me using them to get explanation of what works based on their experiences. 
 

Pay a bit more money is your only risk going there

[MarkyM3]

10 minutes ago, Hummin said:

I can recomend Max clinics, since they know more about it than normal dr’s and been totally worth it for me using them to get explanation of what works based on their experiences. 
 

Pay a bit more money is your only risk going there

OK cheers. I did message Pathlabs via FB Messenger asking about the tests I want but I'll try Max if I get no joy there.

 

I'm only in Thailand for a few more months before I return to UK and I'm planning to hire a private specialist as soon as I get back. I get it all free on public health for now (and probably can continue to get T via that method) but my experience is I probably know more about TRT than the endos I've had assigned to me. One of them tried to prescribe 1mg of Anastrozole per day - <deleted>...I obviously declined. 

Edited May 1, 2022 by MarkyM3

[Hummin]

What most forget, or dr forget to teach their patients, is that trt is not a miracle medicine if not follow up with lifestyle such as sleep, food, drinks, and exercise to make the medicine work for you. 
 

Yes it can be kick in the beginning, but it is a medicine that makes your brain adopt to it, and also adjust its chemistry as well. After 6 months there is no way back when first started, your brain most likely have suppressed most of its own production by then.
 

 
 

 

[chalawaan]

2 hours ago, greg71 said:

I think they charge 9000 baht for the blood tests , which you can get done your self at a lab for about 3000 baht tops 

And surely the meds are going to be cheaper shipped from India. I was tipped about a reliable supplier in India called Oddway. We ordered a generic for the wife's Dad's prostate cancer. Reliable and cost effective. 

I hope this helps one of you here, and do report back on Oddway as I am just exploring TRT myself.

Still learning from many of you here!

Fun fact India is the worlds largest supplier of pharmaceuticals. 

 

Edited May 1, 2022 by chalawaan

[chalawaan]

1 hour ago, Hummin said:

What most forget, or dr forget to teach their patients, is that trt is not a miracle medicine if not follow up with lifestyle such as sleep, food, drinks, and exercise to make the medicine work for you. 
 

Yes it can be kick in the beginning, but it is a medicine that makes your brain adopt to it, and also adjust its chemistry as well. After 6 months there is no way back when first started, your brain most likely have suppressed most of its own production by then.
 

 
 

 

Whoa! That's not what I want to happen. I didn't think it turned off the taps, but was supplementary. Maybe I will pass, being horny all my life wasn't necessarily all that great all the time either!

[Hummin]

3 minutes ago, chalawaan said:

And surely the meds are going to be cheaper shipped from India. I was tipped about a reliable supplier in India called Oddway. We ordered a generic for the wife's Dad's prostate cancer. Reliable and cost effective. 

I hope this helps one of you here, and do report back on Oddway as I am just exploring TRT myself.

Still learning from many of you here!

Fun fact India is the worlds largest supplier of pharmaceuticals. 

 

Testosterone is something you do not want to go cheap on. Bayer 250mg enenthate is available through farmacies  in Thailand for 200 - 250 baht ampulle.

 

Stay away underground labs that often available in farmacies in tourist areas 

[Hummin]

4 minutes ago, chalawaan said:

Whoa! That's not what I want to happen. I didn't think it turned off the taps, but was supplementary. Maybe I will pass, being horny all my life wasn't necessarily all that great all the time either!

You can do 6-9 week cycles two times a year, but still you risk the same in worst case.

 

Most bodybuilders is on TRT from quite young age after started with steroids, and even had a designed cycle for not happening, it still affected them greatly.

[greg71]

8 minutes ago, chalawaan said:

And surely the meds are going to be cheaper shipped from India. I was tipped about a reliable supplier in India called Oddway. We ordered a generic for the wife's Dad's prostate cancer. Reliable and cost effective. 

I hope this helps one of you here, and do report back on Oddway as I am just exploring TRT myself.

Still learning from many of you here!

Fun fact India is the worlds largest supplier of pharmaceuticals. 

 

20 x 1ml 250mg test e costs me 3700 baht . 

[Hummin]

3 minutes ago, greg71 said:

20 x 1ml 250mg test e costs me 3700 baht . 

That's a good price. Useally 4500,- I paid at Facino pharmacy latest during the absence of Bayer.

[Hummin]

22 hours ago, greg71 said:

I think they charge 9000 baht for the blood tests , which you can get done your self at a lab for about 3000 baht tops 

@MarkyM3
 

Here is the complete list of tests they charge 9k for. 

[MarkyM3]

1 hour ago, Hummin said:

@MarkyM3
 

Here is the complete list of tests they charge 9k for. 

Hi Hummin...thanks for the info. I've been in touch with them today, as it happens.

 

They didn't try to sell me that package except as part of a screening for joining their TRT program, which I won't be since I'm already under treatment in the UK, where I reside most of the time. I don't need the bits outside of the hormone panel because they are stable for me over time. 

 

I've asked for the following:

 

Free T (T + SHBG + Albumin)

E2

Prolactin

Thyroid (TSH + free T4. I'm take 50mcg Levothyroxine for hypothyroidism so free T3 isn't useful to check)

 

Cost is 5000 baht. I did check with the place Greg mentioned and it was barely any cheaper. Plus I live in the Sukhumvit area anyway, so I'm going to go with these guys.

 

I already use Tostran gel daily applied so I've asked if they can do the blood draw mid-afternoon, to try and get a T figure roughly between peak and trough. Will see.

 

Cialis was also mentioned in this thread. I did use daily 5mg for some time and I have read studies show that it has suppression effects in the long term on aromatisation of T to E2. So I'm feeling that plus using Anastrozole use may have pushed my E2 down too far. I'll be interested to see, anyways.

 

Seems some treatment places are favouring the daily use of 2.5 or 5mg Cialis now as it apparently has other favourable properties in the endocrine system, rather than for it's usual use for ED treatment. 

 

Do you use HCG btw? UK public health doesn't prescribe it as an adjunctive to T. It's either or, whereas private specialists seem to be more into the idea of using both. Certainly, it's something I want to look at with a private TRT specialist, along with the rest of my treatment protocol, when I return to the UK.  

Edited May 2, 2022 by MarkyM3

[Hummin]

2 minutes ago, MarkyM3 said:

Hi Hummin...thanks for the info. I've been in touch with them today, as it happens.

 

They didn't try to sell me that package except as part of a screening for joining their TRT program, which I won't be since I'm already under treatment in the UK, where I reside most of the time. I don't need the bits outside of the hormone panel because they are stable for me over time. 

 

I've asked for the following:

 

Free T (T + SHBG + Albumin)

E2

Prolactin

Thyroid (TSH + free T4. I'm take 50mcg Levothyroxine for hypothyroidism so free T3 isn't useful to check)

 

Cost is 5000 baht. I did check with the place Greg mentioned and it was barely any cheaper. Plus I live in the Sukhumvit area anyway, so I'm going to go with these guys.

 

I already use Tostran gel daily so I've asked if they can do the blood draw mid-afternoon, to try and get a T figure roughly between peak and trough. Will see.

 

Cialis was also mentioned in this thread. I did use daily 5mg for some time and I have read that it has suppression effects in the long term on E2. So I'm feeling that plus using Anastrozole use may have pushed my E2 down too far. I'll be interested to see, anyways.

 

Seems some treatment places are favouring the daily use of 2.5 or 5mg Cialis now as it apparently has other favourable properties in the endocrine system, rather than for it's usual use for ED treatment. 

 

Do you use HCG btw? UK public health doesn't prescribe it as an adjunctive to T. It's either or, whereas private specialists seem to be more into the idea of using both. Certainly, it's something I want to look at when I return to the UK.  

You and me is about same age, and I also share same experience using anastrozole and also my described experience with nebido. 
 

Im not using HCG since my dr didnt see any reason for it, and Im not going to have babies either, and then it sould only be for «cosmetic» reasons concerning my balls. 
 

If I wanted kids later, they could help when needed. 
 

It is also important to know estradiol is self regulating with the amount of T you have excess, and therefor important to find your optimal dosage so there will not be necessary to add any treatment. 
 

I read about trt dosage pr week up to 500 ml (former bodybuilders) and all the way down to 75mg, or gel 50 mg to 100mg pr day, and also gel and injections combined. 
 

Maybe a different T ester would work better on you? 
 

 

[MarkyM3]

1 minute ago, Hummin said:

You and me is about same age, and I also share same experience using anastrozole and also my described experience with nebido. 
 

Im not using HCG since my dr didnt see any reason for it, and Im not going to have babies either, and then it sould only be for «cosmetic» reasons concerning my balls. 
 

If I wanted kids later, they could help when needed. 
 

It is also important to know estradiol is self regulating with the amount of T you have excess, and therefor important to find your optimal dosage so there will not be necessary to add any treatment. 
 

I read about trt dosage pr week up to 500 ml (former bodybuilders) and all the way down to 75mg, or gel 50 mg to 100mg pr day, and also gel and injections combined. 
 

Maybe a different T ester would work better on you? 
 

 

Yeah, I'm coming around to the view that anastrazole isn't helping, either with the Nebido I previously used or the Tostran I used briefly in the past and now again. I need to work on optimising the T dose and method of delivery. The UK public health system has quite narrow treatment options defined, whereas private consultants don't. Hence my need to get a proper TRT specialist involved after 3+ years of treatment not working consistently. 

 

My case is also probably more complex than most. The origins of my low T may well be due to having to take an anti-epileptic drug (Epilim) from my mid 20s. Unfortunately, it kills T and libido/erections in a fair proportion of men, though I never found that out until I was into my 40s..... Someone told me HCG monotherapy should have been 1st port of call for treatment because that would stimulate LH production in my brain, telling my balls to make T and sperm, which the Epilim apparently messes up. Unfortunately, most endos have no knowledge about this stuff. I found out by doing a lot of research. But my age (51) is probably also a much bigger factor now, 

 

HCG...still haven't ruled out having kids even though I'm now 51 so that's my primary motivation there. But I did read it has other potential benefits though, as well. But if you are feeling good on your TRT protocol and kids aren't a factor then I agree no reason to use it. 

 

Looks like I have my bloods appointment with Maximum on Friday afternoon and I'll get the results within 24 hours.

[Hummin]

27 minutes ago, MarkyM3 said:

Yeah, I'm coming around to the view that anastrazole isn't helping, either with the Nebido I previously used or the Tostran I used briefly in the past and now again. I need to work on optimising the T dose and method of delivery. The UK public health system has quite narrow treatment options defined, whereas private consultants don't. Hence my need to get a proper TRT specialist involved after 3+ years of treatment not working consistently. 

 

My case is also probably more complex than most. The origins of my low T may well be due to having to take an anti-epileptic drug (Epilim) from my mid 20s. Unfortunately, it kills T and libido/erections in a fair proportion of men, though I never found that out until I was into my 40s..... Someone told me HCG monotherapy should have been 1st port of call for treatment because that would stimulate LH production in my brain, telling my balls to make T and sperm, which the Epilim apparently messes up. Unfortunately, most endos have no knowledge about this stuff. I found out by doing a lot of research. But my age (51) is probably also a much bigger factor now, 

 

HCG...still haven't ruled out having kids even though I'm now 51 so that's my primary motivation there. But I did read it has other potential benefits though, as well. But if you are feeling good on your TRT protocol and kids aren't a factor then I agree no reason to use it. 

 

Looks like I have my bloods appointment with Maximum on Friday afternoon and I'll get the results within 24 hours.

Great if you share your experience.