Mike Kocsis from Balance My Hormones UK discusses the recent shortage of Sustanon (January-February 2023) in the UK, and he gives tips on how to manage a testosterone supply shortage for men on TRT (Testosterone Replacement Therapy) and for trans men.
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So welcome back to the trt and hormone Optimization YouTube channel and back With us as a guest from the UK is Mike Cox's welcome Mike hi Stephen yeah Thanks for having me again on on here it Seems like every time I'm coming on I'm Whinging about some problem with some Other regulatory body or government or The news uh the newspapers or uh but I've got some interesting news today and I wanted to share this with everyone who Subscribes to your channel uh to let Them know and and put their minds at Ease by giving them an explanation of What's going on here in the UK it might Give people some tips around the world About how to manage when this happens to You in your country and so that's Essentially what I posted on my channel Balancer hormones was the supply Shortage of Sustanon and we had a little Bit of a clickbaity type title uh called You know assassin on game over because Essentially that's what we're feeling is Is it really worth you know trusting the Supply of Sustanon as your go-to for trt Though someone else pointed out a double Meaning saying that game over is that Replying to to balance my hormones but No we're just getting started so no that Doesn't mean mean that but uh actually One of my employees had mentioned it What we're trying to talk about and let People know is since probably uh
December or end of December early January we've been hearing Rumblings out There about patients not being able to Get their sustain on now that wasn't the Case at my pharmacy at my clinic because You know we have been able to manage our Supply in in the right way and we Specialize in hormones so we would of Course have have enough to cover our Patients and we have a certain quota to Match it but we were hearing Rumblings Out on forums and other locations we Noticed a few time supplies and and Deliveries and income as expected from The wholesale and we were told it's a Minor disruption which can happen Sometimes in the supply chain we weren't Aware of is how long this is going to Last and when uh we got an additional Supply at one point point I believe it Was uh in January a few more supplies And then they're nothing and we were Waiting and we're waiting and waiting And so you know it's very frustrating When you don't know when you're going to Be able to supply your patients and You've got orders piling and piling up And you need to satisfy that that demand And so fortunately you know we have Other other options I'm not dependent There are some clinics in in the UK in Particular who depend on other outside Pharmacies and allow the patients to go Will they nearly get the prescriptions
Filled in kind of the old-fashioned Model but that has caused uh disruptions Themselves so when one Pharmacy doesn't Have it or they run out then patients Look at other pharmacies and they run Out as well and any backups that would Be changed to would run out so that's What we've seen across the board because Of some adversity I'd gone through as a Pharmacy owner and owner balancer Hormones I was able to prepare for this Eventuality you know it made me think Well how do we you know manage this in Future so I was able to have some Backups in place and one of those Backups you know this testoster Incipionate testosterone nanthate we Like to have a full you know arsenal of Different hormones so different Testosterons available because I've Always said there isn't one gold Standard testosterone treatment it's a Treatment that's going to work best for That individual patient and look Sustanon is a bunch of different Esters S is a fatty acid molecules you know Some no longer some are shorter chains At the end of the day it's testosterone Some patients may do better with with These based on the formulations based on The excipients for instance testosterone Enanthate there comes from certain Manufacturers that's Iraqis oil similar To what Sustanon has sustan has arakis
Oil and for some patients this Iraqi Soil can be irritating sometimes the Racket soil and we found in the Enanthate that there wasn't we have not Seen any irritation with that particular Formulation of testosterone but we do See it with sustenron so perhaps it is a Combination of maybe the benzoyl Concentration and Sustanon that we're Not seeing with with the other Preparations that use arakis oil but Even so if you have an allergy to Peanuts or or soy potentially you don't Want to use something with a racket soil In it so yeah having having a backup has Helped but what's so frustrating and What I what I try to emphasize in my Video was and then we had no timeline so This is going on all the month of January or the month of February and We've got no Supply so our supply of Sustalon had lasted us up until I say About the beginning of February because We were properly allocated and you know We matched our quota but once that ran Out it was like you know what are we Going to do when will the supply come Back and you know I was calling the Wholesaler I was calling the Manufacturer some people didn't want to Tell me what's going on so that was the Most frustrating part because we felt Like we deserved to have an answer to so We can tell our patients what to expect
Because let's face it when patients Especially patients who are newly Prescribed testosterone it can be Anxiety with them and patients don't Understand so one of the tips I wanted To give to your viewers and to you know Any of our patients watching is that you Start with a testosterone stay on the Testosterone that you're prescribed one Of the things people should realize is That when they go into soulstone Throughout their life there may be many Supply chain disruptions and you may be Put on many different types of Testosterone and the bottom line is that Little medication this little box it Doesn't matter what it says on the box As long as you're getting testosterone And knowing that as my good friend Dr Krieger from California said when I First started wondering what would Happen if I ran out of testosterone he Said you'll never run out of Testosterone life always finds a way so That you can get your medication and That's a little bit what I guess what I'm trying to tell people is that Through our own resource there are Preparation you know for our patients We've got them covered we'll do the best That we can to to move them over to Alternatives just being aware that you Can switch Alternatives and even if You're it's not ideal but you know a few
Days out to a week out you're not going To become hypogonadal overnight again But that is the anxiety that men have Right if they're going to miss it then Somehow they're going to revert to the Former State and no one wants that and We we don't want people to have the fear And anxiety around that so we do the Best we can to minimize it but what I Wanted to let them know is it's okay I've switched personally prior to all my Years of using social and it was Cypionate I was prescribed sipping Aid To the United States it was the standard There or if you another thing it wasn't Really prescribed much in the U.S but I Guess it depends on the region of where You are and then you know living and Working in the UK Sustanon was a go-to And people will ask us they'll ask us to Say well you know why does balancer Hormones prescribe Sustanon at all I Think a lot of people don't realize that In certain countries like I think in in Belgium Sustanon is licensed in the Netherlands Susan is a licensed product And in the UK it's licensed so what it Means to be licensed is you've got a Marketing authorization as a company Aspen does to sell the product and some Of the guidelines around good medical Practice is that the doctor should Prescribe what's the license in the Country of origin so we've got very few
Choices if that were the case but Fortunately unlike the United States Which is a very much a closed-loop System you can really only get FDA Approved medications and anything else Has to have a very very special Permission from the FDA and if it's Controlled substances the DEA you can't Bring in those medications so we're Fortunate in Europe because we have Agreements with other European countries Even after brexit in order to import These medications and and that's what We've been able to do and they're Considered unlicensed but the doctor Should always be prescribing the Licensed medication first and so we we Try to be ethical follow those guidance And that's that's what we've been doing And we think that was the right thing to Do but we also had instances of cases Where the medication that was licensed Doesn't always shoot the patient's needs So at the same time we've also had the Testosterone cypionate which we had for Years now testosterone propionate Testosterone enanthate in a smaller form A smaller package which means patients Aren't wasting the other half of their Medication it means patients are getting More precise dosing even the multi-dose Vials of cypionate you know to have that On on offers so to kind of match up with What I've said in the past American
Style trt but with British sensibilities And that's that's what we're you know We're trying to do how is offering so if You are you know a person living in the United States and you've moved over to Europe or the UK we can pretty much Match what what you're on in the USA and This has happened before so anyway Getting back to the story what what's Happened so when I discovered through Calling the different manufacturers or The the manufacturer of susteron you Know and there was some information that They were telling me essentially they Said the home office was blocking this So again they wouldn't confirm nor deny Was actually happening but the sense of It is the home office for whatever Reason either didn't renew the license For the manufacturer or didn't renew it In time possibly because they Manufacture either forgot or was late or Had incorrect information on their Application and so they were punished by The home office now people say well what The home office have to do with it they Have to do with immigrants they have to Do with but in the UK the home office a Portion of remit is to manage domestic Licenses for medications anything that's A controlled substance if you possess a Controlled substance not of your Pharmacy but if you're like a wholesale Dealer a manufacturer they would need to
Have a license renewed every year They're not cheap I think like 5K to Renew them with home office but maybe a Little bit less than that but it's it's A lot of paperwork you have to have an Inspection they need to make sure that Everything's locked up and secured Properly it's just a bureaucracy that's That's what you have to do in addition If you're handling medications you also Have to have a wholesale a dealer's License manufacturer's license which Goes to the equivalent of the FDA called The mhra and um I think what's it called In Europe now we used to have it here in The UK but it was the EU version of um European medicine agency EMA yeah EMA Yeah so that's you know essentially what You have to deal with so because of all These different regulators and this is My point this is my point why regulation To this degree doesn't make any sense What they should have done it should Have mhra handle any medicinal product That's controlled and just leave the Home office to regulate cocaine or Whatever other drugs that should should Not be part of medicines but that's just The way it is in the UK a little bit uh Clunky and uh and very much dragging you Down with this bureaucracy so anyway Call the home office as I said in my Video and I was asking hey what's going On with this particular situation with
Sustanon they wouldn't speak to me they Wouldn't speak to me at all like oh you You know what how dare you call us like Well I'm a concerned Patient Advocate Right we've got patients that need the Medication he said we won't tell you About the specific case I said okay well Let me ask you about a hypothetical case And that's what I brought up I'm a Hypothetical pharmaceutical company we Forgot to renew our license in time What's the worst that's going to happen To us you know I said are you going to Pull off our fingernails chop off our Hands so you're gonna you know how how Serious is the punishment and then go Down too well actually talking that Story but he said well you know Um I I don't know where you're going With this conversation I said well I Just I'd like to know I'd like to know What what is the worst that could happen So well that's the misuse of drugs act 1971 or 72 and very very serious I said Okay well how soon would this Hypothetical company be able to get back Up and running and say oh it's no no we Can't say when it would happen and it Was just very very quiet on that topic I Said well what would happen I said how Would you feel about the fact that based On the the what you guys are doing You're hurting you know patients who Really might very much need their
Medication either we don't it's not Really up to us and we've got no feeling About it at all he said all we care About is the regulation and and that's Essentially and I I you'll find this in Any country really you'll get this Certain group of people the control Freaks I call them that just want to They don't care and there's no priority There's no sense of urgency and then They wonder why patients are you know Dissatisfied with the level of care and This just doesn't affect private care This also affects NHS patients and we Even had I didn't say my video we even Had the pharmacy I don't even advertise My Pharmacy it's it's there to service And support balance performance but we Had patients calling us because as a Pharmacy based on the nature of our License we have to have a website Patients found us called us from the NHS Because they couldn't get their Medication on the NHS and they were Switched from Sustanon to enanthate but There was a run on an anti so there's no Announce date left and they were asking If there's anything that we can do so That's how frustrating it is for Patients and how sad it is that like People can't even get their medications I know some patients have been put on Libido as well or testosterone Undecanoate as an alternative so that's
What's happened I was frustrated I put Out the video I think we even tagged Rishi sunak in the home office and oh The other bit the final bit of the story As I said in my video was um they did Give me a little hint the home office And they said well in order to enlarge It the home office would have to get Permission from the Department of Health And that's how another bureaucracy to go Through you can't even get a hold of Anyone I did what I thought was my good Citizen Duty and I I reported to the Supply chain people in the Department of Health got a few emails back but it's Very top level and and no one really Recognized that they knew that this Problem existed they just took my Information and left it that I had a few Inside contacts that I tried to message On LinkedIn that I tried to email and They just either on holiday or didn't Read the emails or you know buried it so You know we've got nowhere with them and Then finally this week just for just out Of curiosity I thought well you know who Knows how long this is going to go on Let me let me give the manufacturer a Call and to my surprise and I was Whinging and complaining all morning Thinking oh yeah we have to just prepare That there will be no more susten on it Like I put in my video sassan on game Over we found out again questionable if
We believe them because we've been down This path before but they said and maybe By the time this video is out they said You know the Sustanon will be coming Back and pharmacies that have licenses Or have the agreements with the Wholesaler can place their orders Starting next week so hopefully by the Time the video comes out people will Watch this they'll have Sustanon Trickling back into the market balance For hormones patients have been you know Fine throughout this for the most part People were able to get a substitute and And we're really happy that we've been Working overtime to do it and that was The other part about it Stephen I mean I've been rolling up my sleeves you know Mucking in calling patients trying to Put their mindset he's letting them know What what's going on because you know It's really unfair like these decisions By these Regulators don't take it into Account all the extra work that you have To do as a business that support it so I Mean we've got lots of Staff but if we Have to replenish every single Prescription it's you know you know as a Doctor there's a lot you've got to do You've got to make sure the blood tests Are up today you know you do all these Checks before you write a new Prescription you just write a new Prescription really nearly so there's
These very sound checks that have to go Into place and that's what we had to do So everyone you know did what they could To to kind of move through the list so But anyway the good news is hopefully if We're not being fooled or Bamboozled by The by the government and and the Wholesaler then we should be getting our Our supplies back for our patients and That's good news for the NHS patients And other patients in the UK as well Yeah Amazing Story really incredible and The basic question remains of course why Is this was thrown in the first place uh Control substance right exactly and that Was that was the kind of the big picture That I want to talk about and you know I'm not the only one that has mentioned This we know that there's some talk in The United States about it has to do With the almost a trans Community or Pushing this and this is comes from the Work of Rick Collins he's mentioned this But it's it's a it's a question that Anyone who's on testosterone would Rightfully ask you would say well during The midst of the Easter dial shortage or Estrogen shortage we understood that That was an issue due to a manufacturer Not getting the supply that's increasing Demand okay we get that but estrogen is Not a controlled substance so they only Have one regulator to deal with it which Is the the medicines agency or the
Equivalent of the FDA for the people in America that watch it but they don't Have to have the DEA or the home office Involved and that complicates things it Complicates it when you're trying to Import the testosterone from other Countries because the DEA gets involved From the USA just to export the Medication it gets involved with just Use of it in individual countries even Throughout Europe you throw in the Doping laws as well and some European Countries you can't get any reasonable Testosterone unless it's gels are Undecinoate and so you've got very Limited options and it's going to take You longer to get dialed in if at all But I suppose for those unfortunate People in Sweden Norway sometimes Denmark but Denmark is we're not sure Which way they're going it looks like They're leaning more towards their Friends in Sweden and the rest of Scandinavia you know you do what you you Do the best you can with the tools that You have and some testosterone is better Than no testosterone you know if you're Deficient so and that's that's kind of Where where we sit with that but no the Controlled substance and this is what Rick Collins talks about is very unfair To men it's almost discriminatory Towards men who need this very vital sex Woman and you know as a doctor Stephen
Right the the sex steroids sex hormones The female sex hormones you know uh you Know Easter dial estrogen progesterone The male sex hormone testosterone I Actually get three in one of the Testosterone near DHT and Easter dial Through its conversion and Rheumatizations but generally speaking You know these are things in your own Body why is it being controlled and in Some countries like the USA you can't Even possess testosterone so imagine That loads of men and women from puberty On up to you know adulthood you know are Walking around with a controlled Substance in their body you know based On these laws which is insanity yeah It's truly amazing uh yeah it probably Stems from the the bodybuilding misuse Yeah that's what uh it's funny I did a Quick uh sometimes it is a chat GPT Three yeah yeah I've tried it yeah and I Asked chat TPT I said well what do you Make of you know before this video I Said controlled substances and Testosterone and what did it say is due To abuse and I also said well what what Do you mean by abuse oh it can be used By bodybuilders and using a non-medical Way okay well so can alcohol so can many Other items other things that people Take so you know paracetamol you can Take too much there are so many Medications that can be but apparently
There's stigma around testosterone and That's what I talked about in my talk in In Las Vegas is the stigma I think Pushes people into this also this So-called fairness in sport and that Really makes me angry because you know Yes I I like sport as much as the next Person that should not interfere Sport And the rules around sport should not Interfere with good medical care it's Really unfortunate menopause for women They've got you know good access to when The supply is there to for to their sex Steroids to their hormones and males Can't get it testosterone but you know What there is a crossover and women now On HRT are seeing the benefits of Testosterone treatment along with the HRT and so perhaps as this becomes more Popular because it's medically necessary Not because it's just popular but again There's always a risk when more and more People gravitate towards something as They learn of the of the health benefits Then the regulators and the government Starts cracking down on it because of Its there's too many people and they Have to control this and that's that's Frustrating I think a lot of people you Know during other times the the other c Word that we lived through for two years Also saw some of this exercise of Governments around the world to control People for much longer than they
Probably should have done in the name of Of safety and so that's when you end up Giving away you know some of your Freedoms in the name of safety and we Have to be careful about this so that we Don't lose our freedoms and that's That's really important and that's kind Of why I I'm not trying to get on the Soapbox but it's so important in all Walks of life that if you want to Maintain Democratic freedoms you have to Exercise your rights and you have to Speak up and you have to let people know That this isn't right and you're not Going to stand for it and your vote for People who will hopefully do what they Say they're going to do I mean there are People charlatans that will say one Thing in his office and do another or And that discourages people but in General if you can find you know the Right people to to vote for hopefully we Start making a change and we can create A movement around this then then we can Make a change as well as I've already Talked about on this channel uh seems to Be a a war on manleyhood on masculinity And that's the whole point masculinity Has become toxic in certain eyes and we We can't understand why being a man is So toxic at the first place so yeah Strange things are going on yeah it does Make you wonder lots of our patients and People that watch the video made the
Comments this is an attack on men this Is an attack on masculinity and I think This comes out to the so-called culture Wars right these culture wars they were Instigated probably by both political Sides right the left the right everyone Um we're one group has some ridiculous Ideas and then the other group you know Amplifies it to show how ridiculous the Other group is and this is this back and Forth but there is there does seem to be Attack and attack and all things a bit More traditional I think the way things Used to be and it's maybe it's going too Far in One Direction where things just Don't make any sense anymore if one plus One equals two you'll get some group That say no it equals three or another Number and I think that could be very Frustrating but this toxic masculinity Because I've been asked about this on Other channels as well as on the Muscular development Channel else hey What do you think about this toxic Masculinity and like from from what Point of view what do I think about it You know I don't think it was an issue Until it was brought up there is trying To relate it to what do you think about It along with testosterone therapy and My answer was well if you if you're Going the route of saying you know if Someone goes on testosterone treatment And they become an chances are
They're an before they started The treatment right but no the point is If they're not a nice person before they Start trt they're probably not gonna be That nice of a person but there are many Cases when there are the people who are Answering nice before this art trt the Reason why they're not so nice is Because the testoster is too low they've Got this hormone imbalance and the Testosterone will bring them back up to A level being a really nice person and We can see that with some of our our Patients who are very full of the Anxiety full of frustration and the Longer they're on treatment the better They become for the most part yeah Amazing story thank you so much for Sharing all this Mike thank you for Having me on there happy to contribute You're doing great with the channel and I like having the collaboration because I think that's what's about we all Sticking together in the trt community To create that awareness and kind of Create a movement to you know what I Call origin I say it's the free of the T Movement right let's free the tea and Let's stop the stigma around Testosterone and let's make sure and Women can get their testosterone Treatment because it's just as important For women okay so uh thank you so much Mike for this incredible story and um
Let people know how to contact you yeah So please contact us at Balancemyhormones.co.uk or also visit my YouTube site which is also balanced for Hormones we're also on Instagram and Twitter and Tick Tock and really all the Social media but the big ones that we've Been focusing on is is the YouTube Channel and we love having the Collaborations with you Stephen So yeah Thank you I'll put all your links in the Description of this video thank you Mike