madman
Super Moderator
@Marcel
www.excelmale.com
We have always been far worse off than the US when it comes to the treatment of men for testosterone deficiency.
Although there has been some improvement in certain areas we are still lacking in many others.
*In 2013, a comprehensive Canada-wide needs assessment revealed that over 25% of Canadian physicians were uncomfortable with the diagnosis and treatment of TD and identified significant knowledge gaps related to patient management.4 To address the knowledge gaps, the “Canadian clinical practice guideline on the diagnosis and management of testosterone deficiency syndrome in adult males” was published in the CMAJ.5 As part of its mandate, the guideline was offered as a “living document,” to be updated
Most doctors especially endos and GPs would not treat a man who is suffering from symptoms of low-T unless his numbers are flagged low (reference range).
Even then there are many men who can suffer from symptoms of low testosterone even with a TT hovering on the low end (low-normal) of the reference range yet your doctor keeps telling you that it must be something else because your T levels are still in range.
Clueless as to where the unbound active fraction responsible for the positive effects sits. Got FT, anyone!
Gets even nuttier as there are many men with what would be considered a robust TT 500-700 ng/dL but are still suffering from symptoms of low testosterone due to highish/high SHBG which would have their FT levels low/low-normal of the (reference range).
Most doctors are still caught up on TT and although it is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.
Many still tend to only look at TT, LH/FSH.
Some may also test estradiol but it is far from common.
Yet they pay no attention to the most critical blood markers free testosterone and SHBG (sex hormone binding globulin).
Even if you do manage to get treatment finding a doctor well-versed in TRT is a feat in and of itself!
Options are slim compared to what is offered in the US, especially through pay-out-of-pocket clinics which are numerous there.
We only have a handful of these clinics and they are expensive.
Most men are being treated by a GP, endocrinologist, or urologist.
I would opt for the urologist if you are seeking treatment and even then finding someone well-versed in TRT would be difficult.
Most doctors are still caught up in the numbers game and seem to be dead set on keeping your levels within a set reference range without understanding that symptom relief is what truly matters
When it comes to formulations available in Canada you are basically stuck with a big pharma transdermal T patch (Androderm), transdermal T gels (Androgel, Testim), transdermal compounded T cream, oral TU (Andriol), nasal gel (Natesto), or injectable T enanthate (Delatestryl) or T cypionate (Depo-Testosterone/generic).
The majority of men opt for injectable TE or TC as they are the most effective when it comes to increasing your T levels, especially well beyond the physiological range let alone the cost is much cheaper as your private or provincial health plan covers the costs in most cases.
Pipe dreams if you think you are going to get your hands on T propionate or the so-called optimal HRT treats such as nandrolone decanoate, oxandrolone, or stanozolol which is easy to come by if you were being treated in the US.
These would all be considered illegal to prescribe in Canada for HRT.
Nandrolone, oxandrolone, and stanozolol may be prescribed for certain medical conditions although far from common.
When it comes to blood work and testing methods we are still way behind compared to the US.
Although TT used to be tested using the standard immunoassay most labs now use the most accurate assays (LC/MS-MS) and although estradiol is still tested using the standard immunoassay we now have the option for estradiol sensitive (LC/MS-MS) through labs such as Dynacare.
Unfortunately when it comes to one of the most important blood markers free testosterone the only option we have is the calculated method as the older outdated known to be inaccurate direct analog immunoassay was phased out in 2014.
Many fail to realize that we do have access to what would be considered the most accurate assays for free testosterone such as the gold standard Equilibrium Dialysis or Ultrafiltration but the cost is absurd and is not covered by your provincial health plan.
This is unfortunate and needs to be addressed as it is critical to know where your FT level truly sits.
Although most should be using/relying upon the most accurate assays when testing FT, especially in cases of altered SHBG the cost of such testing methods for Canadians is too absurd.
As you know blood work is done through your treating physician and is usually done every 6 months on trt.
Your private or provincial health plan covers the costs.
*The federal government provides health care funding to the provinces and territories through the Canada Health Transfer
Unfortunately, we only have a few options when it comes to paying out of pocket for private testing which I have mentioned in previous threads.
This would be done through About Blue Horizon Medicals | Blood Testing Services in Ontario and is only available for Canadians living in the province of Ontario, Quebec, or Manitoba.
Blue Horizon medicals are based in the UK and have a partnership with Dynacare Labs which allows them to offer a private payout of pocket testing.
Unfortunately, BlueHorizon is overpriced and they do not even offer the most accurate assays for free testosterone (ED/UF) let alone estradiol sensitive (LC/MS-MS).
Only worthwhile if you wanted to pay out of pocket for private blood work to check your Total Testosterone, SHBG, Estradiol (standard), prolactin, and CBC.
The only place you can get the estradiol sensitive is through Dynacare which would need to be requested by your treating physician and you would be stuck with paying out of pocket as it is not covered by your provincial health plan.
Canadians also have the option of ordering blood tests through Nelsons discountedlabs.com which will be done at Quest Diagnostics but you would need to find a location close to the border as you will have to drive across the border to have blood work done.
The main benefit is you would have access to the most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration) let alone the prices offered by Nelson are reasonable (USD currency).
$43.06 USD ($63.58 CAD)
$76.38 USD ($105.43)
$97.85 USD ($135.07)
$200.21 USD ($276.36)
$203.61 USD ($281.05)
THE DEA And ACCESS TO TRT TELEMEDICINE
It only took 22000 comments and a few congresspeople to stop the DEA from scheduling kratom, and that was with 60 days to comment. We are up to -15k comments and at least 6 congresspeople and two senators with one week left to comment and a far stronger case than with kratom. If the DEA ignores...
www.excelmale.com
We have always been far worse off than the US when it comes to the treatment of men for testosterone deficiency.
Although there has been some improvement in certain areas we are still lacking in many others.
*In 2013, a comprehensive Canada-wide needs assessment revealed that over 25% of Canadian physicians were uncomfortable with the diagnosis and treatment of TD and identified significant knowledge gaps related to patient management.4 To address the knowledge gaps, the “Canadian clinical practice guideline on the diagnosis and management of testosterone deficiency syndrome in adult males” was published in the CMAJ.5 As part of its mandate, the guideline was offered as a “living document,” to be updated
Most doctors especially endos and GPs would not treat a man who is suffering from symptoms of low-T unless his numbers are flagged low (reference range).
Even then there are many men who can suffer from symptoms of low testosterone even with a TT hovering on the low end (low-normal) of the reference range yet your doctor keeps telling you that it must be something else because your T levels are still in range.
Clueless as to where the unbound active fraction responsible for the positive effects sits. Got FT, anyone!
Gets even nuttier as there are many men with what would be considered a robust TT 500-700 ng/dL but are still suffering from symptoms of low testosterone due to highish/high SHBG which would have their FT levels low/low-normal of the (reference range).
Most doctors are still caught up on TT and although it is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.
Many still tend to only look at TT, LH/FSH.
Some may also test estradiol but it is far from common.
Yet they pay no attention to the most critical blood markers free testosterone and SHBG (sex hormone binding globulin).
Even if you do manage to get treatment finding a doctor well-versed in TRT is a feat in and of itself!
Options are slim compared to what is offered in the US, especially through pay-out-of-pocket clinics which are numerous there.
We only have a handful of these clinics and they are expensive.
Most men are being treated by a GP, endocrinologist, or urologist.
I would opt for the urologist if you are seeking treatment and even then finding someone well-versed in TRT would be difficult.
Most doctors are still caught up in the numbers game and seem to be dead set on keeping your levels within a set reference range without understanding that symptom relief is what truly matters
When it comes to formulations available in Canada you are basically stuck with a big pharma transdermal T patch (Androderm), transdermal T gels (Androgel, Testim), transdermal compounded T cream, oral TU (Andriol), nasal gel (Natesto), or injectable T enanthate (Delatestryl) or T cypionate (Depo-Testosterone/generic).
The majority of men opt for injectable TE or TC as they are the most effective when it comes to increasing your T levels, especially well beyond the physiological range let alone the cost is much cheaper as your private or provincial health plan covers the costs in most cases.
Pipe dreams if you think you are going to get your hands on T propionate or the so-called optimal HRT treats such as nandrolone decanoate, oxandrolone, or stanozolol which is easy to come by if you were being treated in the US.
These would all be considered illegal to prescribe in Canada for HRT.
Nandrolone, oxandrolone, and stanozolol may be prescribed for certain medical conditions although far from common.
When it comes to blood work and testing methods we are still way behind compared to the US.
Although TT used to be tested using the standard immunoassay most labs now use the most accurate assays (LC/MS-MS) and although estradiol is still tested using the standard immunoassay we now have the option for estradiol sensitive (LC/MS-MS) through labs such as Dynacare.
Unfortunately when it comes to one of the most important blood markers free testosterone the only option we have is the calculated method as the older outdated known to be inaccurate direct analog immunoassay was phased out in 2014.
Many fail to realize that we do have access to what would be considered the most accurate assays for free testosterone such as the gold standard Equilibrium Dialysis or Ultrafiltration but the cost is absurd and is not covered by your provincial health plan.
This is unfortunate and needs to be addressed as it is critical to know where your FT level truly sits.
Although most should be using/relying upon the most accurate assays when testing FT, especially in cases of altered SHBG the cost of such testing methods for Canadians is too absurd.
As you know blood work is done through your treating physician and is usually done every 6 months on trt.
Your private or provincial health plan covers the costs.
*The federal government provides health care funding to the provinces and territories through the Canada Health Transfer
Unfortunately, we only have a few options when it comes to paying out of pocket for private testing which I have mentioned in previous threads.
This would be done through About Blue Horizon Medicals | Blood Testing Services in Ontario and is only available for Canadians living in the province of Ontario, Quebec, or Manitoba.
Blue Horizon medicals are based in the UK and have a partnership with Dynacare Labs which allows them to offer a private payout of pocket testing.
Unfortunately, BlueHorizon is overpriced and they do not even offer the most accurate assays for free testosterone (ED/UF) let alone estradiol sensitive (LC/MS-MS).
Only worthwhile if you wanted to pay out of pocket for private blood work to check your Total Testosterone, SHBG, Estradiol (standard), prolactin, and CBC.
The only place you can get the estradiol sensitive is through Dynacare which would need to be requested by your treating physician and you would be stuck with paying out of pocket as it is not covered by your provincial health plan.
Canadians also have the option of ordering blood tests through Nelsons discountedlabs.com which will be done at Quest Diagnostics but you would need to find a location close to the border as you will have to drive across the border to have blood work done.
The main benefit is you would have access to the most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration) let alone the prices offered by Nelson are reasonable (USD currency).
$43.06 USD ($63.58 CAD)
Testosterone, Free (Equilibrium Dialysis) and Total, MS - Most Affordable and Accurate Test
Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.
$76.38 USD ($105.43)
Total and Free Testosterone Test Panel plus Hematocrit
Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT
$97.85 USD ($135.07)
Testosterone (Total + Free), Ultrasensitive Estradiol plus Hematocrit
This economical lab test panel includes the four tests more frequently ordered by men on TRT: Total Testosterone, Liquid Chromatography/ Mass Spectrometry (The most accurate testosterone test with no lower or upper limit).-Free Testosterone, Equilibrium D
$200.21 USD ($276.36)
Testosterone, Estradiol and DHT Panel
Testosterone, Estradiol and DHT Panel This panel contains testosterone and its downstream metabolites: Estradiol and DHT. All three hormones are measured using Liquid Chromatography/Mass Spectrometry (LC/MS), the most accurate assay for hormones. No inter
$203.61 USD ($281.05)
Testosterone, Hematocrit, Estradiol and Prolactin Panel - Most Accurate Assays
Testosterone, Hematocrit, Estradiol and Prolactin lab test panel
