Report: TRT in Chiang Mai - success!

[Pkl]

I thought to contribute a bit myself to this great forum by reporting my experiences about testosterone replacement therapy (TRT) in Chiang Mai. I think the topic has been much discussed before but here are some of my experiences.

Background: I am young (30 years old) male, but for some reason I have naturally low testosterone levels. I have been on TRT since 2010 while I lived in my home country in Europe. Now I staying in Chiang Mai long term and I had to continue to TRT here. After it was about 10 weeks from my last injection, I went to see a doctor here in CM.

About one month ago I went to McCormick hospital and asked about testosterone injections and TRT. The staff asked if I wanted a vaccine

After a little talk, I changed tactics and asked to see an endocrinologist. Of course, the staff didn't know what that is but after using Google Translator for word "endocrinologist" I was directed to Dr. Chalit Ariyapanya. I explained to him about my case: naturally low testosterone, I have been on TRT. He seemed to know at least something about TRT and spoke some English. Since I had no paperwork of my treatment in Europe (yes, stupid of me ), he sent me to have total testosterone and PSA tested. I asked about testing free testosterone too, since total testosterone level doesn't tell much of anything about the need for TRT, but he said that they do not do free testosterone testing in McCormick(!?). He gave me an appointment to come again in 30 days.

The doctor visit and the blood tests were about 2000 baht. Most of the cost was from the laboratory testing.

So, today I went to see the doctor again. This time I had my old test results from Europe that showed my low level of free testosterone and high levels of SHGB. He read my old test results carefully and gave me a prescription of one injection of testosterone. He said that in Thailand, they have only one brand of injected testosterone and that Nebido, that I was using in Europe, was not available. With the Thai testosterone, I would need to get injected every 2-4 weeks, while with Nebido I would need an injection only every 8 weeks. Which is fine by me, especially since he said that one injection of testosterone would cost only 150 baht. In Europe, one injection of Nebido was about 100 euros (4000 baht).

I got my first injection today. The total cost was 700 baht for the doctor visit, the testosterone and the injection that was also done in McCormick. Also the testosterone was bought from their in-house pharmacy. I am sure I would get it cheaper somewhere else, but considering the prices compared to Europe, it was a bargain. The nurse giving the injection seemed to know what she was doing so all good on that part too.

I have my next appointment in 30 days again, when I am assuming we talk with the doctor about the effects of the injection and then we make a longer term plan and I hopefully get prescription for more injections.

To sum it up, in case you live in Chiang Mai and need TRT, I would recommend you to get your free testosterone and SHGB levels tested somewhere and then go to see a doctor such as Dr. Chalit Ariyapanya.

[Pkl]

Just to continue to report my experiences: Had my third appointment earlier this week. This time, the whole thing took less than 10 minutes - registered to the front desk with my appointment paper, I was told where to wait, sat down for 1 minute to get called in by the doctor. He basically only asked me if the first injection caused any side effects. I said no, he said OK and wrote me up for a new shot of testosterone which was again done in the McCormick. He also said that we would be testing the testosterone levels after three months. I was expecting them to be tested already, but I do not mind. I have been doing this so long that I can pretty much feel if I am too low (or too high), and I am feeling just fine at the moment.

I got a new appoint for a new doctor visit and shot for again 30 days.

The 10 minute trip to McCorminck again cost about 700 baht (sorry, I do not remember the exact number), which may seem high, but I still compare prices to Europe, and for that, it's a bargain. And after I get the treatment going on properly with doctor checks with only once or twice a year instead of before every shot, the price should go down a lot.

I'll continue to report here in case someone finds this interesting.

Edited December 21, 2013 by Pkl

[eyecatcher]

That was a good write up.

Now for my benefit and no doubt a few others , can you relate to us how you ever came across this lack of testosterone.

Had your report not been so compelling I would have had a field day asking about man boobs and a high pitch voice ....or even asking if you are a woman.

But seriously is this common and what should we be looking for.

I fear my reputation precedes me now and someone else should have asked this question.

Sent via tin can and string after pigeon shot

[Farma]

Another question out of curiosity.

I was looking through a pharmaceutical wholesale warehouse a couple of weeks ago and noticed 2 or 3 brands of testosterone pills on the shelf.

Do these pills provide the same results as injections?

[Pkl]

That was a good write up.

Now for my benefit and no doubt a few others , can you relate to us how you ever came across this lack of testosterone.

Had your report not been so compelling I would have had a field day asking about man boobs and a high pitch voice ....or even asking if you are a woman.

But seriously is this common and what should we be looking for.

I fear my reputation precedes me now and someone else should have asked this question.

Sent via tin can and string after pigeon shot

I came across this by quite accident, really. I had symptoms of feeling tired, feeling weak, low sex drive (I could get my thing up but didn't have much interest in sex in general). Many times when I woke up in the morning, I felt tired, no matter how many hours I had slept. Another thing was that I have been going to the gym for years but with quite minimal results. No, I am not fat and thus no man boobs, and I think my voice is quite normal too

I was basically searching the Internet about my symptoms and some website suggested that you should have your free testosterone levels checked, just in case. There are many causes of low testosterone for men of all ages. This is really a very complex issue and not even your basic MD knows all this stuff. But basically, the problem can be with the brain not sending the signal to the gonads produce testosterone, or the problem may be in the gonads for not responding to the signal sent by the brain, or there can be too much of SHGB, which is another hormone that very basically put blocks the testosterone from working. All these things can vary based on man's diet, age, medication and whatnot.

So, I had my levels tested back in Europe. My doctor (a specialist of the hormone system) also gave me a symptoms questionnaire of which I scored very high points - high being an indication of low free testosterone, and when the blood test confirmed that my levels were in fact low, it was quite clear what was going on.

After starting the TRT, my feeling of tired and weak have gone away, my sex drive is normal and I basically feel like normal again. The blood tests also show my levels now being in the normal range and the questionnaire score also dropped significantly.

[Pkl]

Another question out of curiosity.

I was looking through a pharmaceutical wholesale warehouse a couple of weeks ago and noticed 2 or 3 brands of testosterone pills on the shelf.

Do these pills provide the same results as injections?

It depends, there are dozens of different forms of testosterone those pills can contain. The thing is that when taken orally, vast majority of the testosterone is broken up and made ineffective way before it gets to your system. Also, when taken orally, the testosterone needs to pass through the liver and this can cause cysts to be formed inside the live. These cysts are permanent and if too many of them are formed, the liver can shut down completely and without proper treatment, you can die.

To solve the problem of testosterone being broken up by the digestive system when taken orally, testosterone needs to be binded with some molecule. This is the reason why there are dozens of forms of testosterone the pills can have. They do not have 100% pure testosterone, because taking that orally simply would be very very bad idea.

The traditional wisdom is that all oral testosterone is risky for liver, especially for the long run, but with some forms of testosterone being more risky and some less risky. However, some forms of oral testosterone come with very low risks of liver damage, especially when we talk about dosage for TRT, one of such forms is Testosterone undecanoate which should be safe to use with TRT dosages in long term.

And oh, one thing one needs to remember: if you start to take testosterone, it can (and in long term will), drop your own testosterone production. This means, you should not And, taking testosterone will reduce your fertility. In fact, the long acting testosterone undecanoate taken as injections, have been tested as a male contraception, and it works for that too

[SeaVisionBurma]

As this is an interesting medical related thread, I'll move this to the relevant section.

Keeping the thread link in the Chiang Mai forum as well given it is CM-specific info.

[Sheryl]

Nebido is available in Thailand.Possibly the McCormick pharmacy doesn't stock it, but it is sold here. Not cheap though as it is imported.

There is also now newly available a topical form, Androgel. A viable alternative to injections.

I'm glad you were able to get what you needed but if at any point you wish to get a higher level of expertise and English-speaking -- at lower cost -- I suggest you see an endocrinologist at Sripat.

[Pkl]

Nebido is available in Thailand.Possibly the McCormick pharmacy doesn't stock it, but it is sold here. Not cheap though as it is imported.

There is also now newly available a topical form, Androgel. A viable alternative to injections.

I'm glad you were able to get what you needed but if at any point you wish to get a higher level of expertise and English-speaking -- at lower cost -- I suggest you see an endocrinologist at Sripat.

Thank you for the info! I was also very surprised when my doc said Nebido is not available in Thailand when I noticed testosterone undecanoate sold as oil capsules - basically the same stuff as Nebido but only in oral form. Do you know what kind of prices are we talking about if one would like to buy Nebido in Chiang Mai?

Also, good point about the topical cream, I had forgotten all about that option! In fact, when I started my TRT, I started by having one injection of Nebido and followed with 3 weeks of topical testosterone cream. The brand of testosterone cream I used (sorry, don't remember the name), seemed to be basically just some thick alcohol base with pure testosterone. When you apply it on your skin, the alcohol quickly evaporates, leaving only the testosterone on your skin to be used by your body.

I personally found the cream to be rather cumbersome to use. First of all, you need to use it every single day. It needs to be applied on a shower clean skin (but the skin must be dry), and it must not be applied to areas of heavy hair growth, nor near the genital area, nor near the face. Recommended areas are the back, stomach and shoulders. Trying to apply the cream yourself to your back or shoulders sounds easier than it is, since the second you get the cream, the alcohol starts to evaporate, which makes the whole cream very runny and you risk all of it dropping from your shoulders to the ground. And after you are done, you need to wash your hands very carefully, so you don't leave traces of testosterone around the house (like the bathroom door knob) for your wife / girlfriend to get by accident

For me, before I started TRT I was also planning on going on with the cream to avoid the injections. With one month on the cream, I was more than happy to just go with the injections

[turgid]

The Nebido availability issues might be because they are tightly controlling the channels. They have not been able to get FDA approval several times (it is now called Aveed in the USA) and presumably they don't want any "misuse" stories that might cause them problems with the current round of FDA approval process due for review in early 2014. This may also be why it is so expensive here. Its about 5000 Baht in the UK. Controlling "grey" distribution is the best way to maintain price across multiple markets.

http://www.news-medical.net/news/20130531/FDA-issues-complete-response-letter-to-Endos-NDA-for-AVEED-injection.aspx

"The FDA outlined the steps necessary to support approval of the New Drug Application (NDA) and updated the requirement for a Risk Evaluation and Mitigation Strategy (REMS). Specifically, the FDA has requested that the REMS include a Medication Guide as well as Elements to Assure Safe Use (ETASU) to mitigate the risks and severe complications related to post-injection reactions"

[Sheryl]

There are no special controls on it in Thailand. Category D which means not even prescription required. But its high cost limits demand especially as there are locally made injectable testosterone preparations. (These are testosterone propionate, whereas Nebido is testosterone undecanoate).

As it is imported, cost here will be somewhat higher than in Europe (drug cost, that is. Doctor fees etc lower).

[Talken1949]

Can you recommend sources where I can buy Testosterone Cypionate OTC here in Chiang Mai? I have my testing history and prescription from the states. All I need are the vials.

Thanks.

[h90]

Always there were are a lot tourists and/or bodybuilder.

So near gyms and places of lower class tourists is a good bet. It is the same real/original product if you abuse it to look like a Gorilla or if you use it for a real medical reason.

[royalmice]

Hi

Great thread.

I am also considering going on the Testo wagon , and been Googling about it.

I live just outside of Pattaya, and i found a Doctor in Pattaya which del with Testosterone – Andropause. It is a Swiss guy, speaks, Swiss, French, Thai and English.

I dropped him a email and got a reply back the next day, below is his reply:

Should you come here we can inject Testoviron once a month (500 baht) or Nebido once every 3-4 months (8,000 Baht). First visit is 900 baht and then usually 700 Baht. Many patients, when Testosterone Replacement Therapy is on track come every month or every 3-4 months and get their injection by the nurse without need of doctor visit

At the beginning often we also test blood testosterone level (700 baht)

Not sure if i can post links but here is his website : https://www.dr-olivier-clinic.com/ if the link dont show, just Google "Dr. Olivier Meyer - Pattaya" He has a website and you can order meds online from him.

My first apointment tommorow for the blood test. The nurse on the phone told me i can get the results the next day.

Will let u know how it goes

[rodknock]

i have had 2 nebido shots, not cheap 12,000.00baht each.

same price 2different hospitals