There’s been lots of hub-bub about the recent testosterone shortage in Canada, with many people expressing surprise that this could happen. When I was considering testosterone therapy and weighing my options, one thing I felt sure of was that because testosterone is a common medication for men — not a “transsexual drug” — I wouldn’t be subjected to shortages. This was naive. In the 3 years and 9 months of being on testosterone, I’ve experienced not one testosterone shortage, but four. Testosterone shortages seem to be quite common here in Canada.
I started on Testosterone Cypionate, which in Canada is branded as Depo-Testosterone (aka Depo) and made by Pfizer. In December 2008, there was a Depo shortage and my pharmacist substituted Testosterone Enanthate, aka Delatestryl, then made by Theramed. (Aside from custom compounds, Depo and Delatestryl are the only injectable testosterone preparations available in Canada.* We don’t have Sustanon, Reandron, Omnadren, Nebido et al.)
I wrote about the differences between Testosterone Cypionate and Enanthate here. Chemically speaking, they’re practically the same, with the main difference being the concentration of testosterone offered by each brand:
- Depo-Testosterone (cypionate): 100 mg / ml
- Delatestryl (enanthate): 200 mg / ml
The only payload of this is that when I’m using Depo, I have to inject twice the volume. Initially, a 2cc shot looked a little intimidating, but it’s really of no issue.
In August 2010, I picked up my Delatestryl at the pharmacy and… Surprise! The price had doubled. Nevertheless, I stayed on Delatestryl (for the smaller injections) and then in the summer of 2011, there was a shortage. My pharmacist had no information about this, so out of curiosity I called Theramed myself. They were less than helpful. I spoke with my dollars and switched back to Pfizer’s Depo-T rather than wait for Delatestryl to return to market, and was pleased to find out that Depo had actually had come down in price by a whopping $3. Win!
Fast forward just a few months and I started hearing about another Delatestryl shortage rearing its head at pharmacies across Canada in late November and December, 2011. That story got a bit bigger when Benjamin posted this video. I commented on it, offering up the straightforward solution: get your doctor to switch your prescription to Depo. Hassle over, plus pay half as much. However, by the time reporter Katie Toth picked up on Benjamin’s story and was quoting officials from Toronto’s Sherbourne Health Centre advising trans men that “they can be switched to a different compound,” I’d found out while trying to get my prescription filled that there was now also a shortage of Depo. We weren’t just talking about a shortage of T, this was now a full outage.
Aside from the misinformation about access to Depo in Toth’s articles that appeared on Xtra.ca and Rabble.ca, I think Toth missed some other important points:
The articles failed to mention the without-warning price increase of Delatestryl. (The Xtra article also has incorrect information about Delatestryl pricing… I don’t know anyone who goes through a vial of Delatestryl in a month.)
I spoke to my doctor about the testosterone shortage outage, and he said that he believes many drug shortages are “orchestrated” to drive up demand and prices. This leads me to wonder… Will Pfizer increase the price of Depo soon? My sister, who’s a doctor, mentioned that fertility drugs have recently gone up in cost as well. I don’t know much about the hormone protocols for trans women, and wonder if this has impacted Canadian trans women at all? Big Pharma knows hormones are Big Business. Is there some kind of legislation in place in Canada that prevents Valeant, Pfizer and friends from setting pricing to their whims?
Also, I think it’s important to note that testosterone shortages affect all men using therapeutic T, not just trans men. Here in my small community of about 1000, I’m the only trans man but I know there are several other men on T. I imagine being off it would affect us differently, but I don’t want to compare who has it worse. Suffice it to say that without our prescribed medication, we probably all feel off.
Testosterone Shortages Are More Common Than You Think
You’re less likely to feel the effects of a shortage if you live in an urban center. My pharmacist told me that as a controlled substance, a drug that not a huge number of people are on, and one that’s dispensed in amounts that last for several months, testosterone isn’t heavily stocked in pharmacies. This is especially true in small towns. Pharmacies rely on their distributor to have stock. When your pharmacy, their distributor and the manufacturer are all out of stock, that’s when YOU will experience a shortage.
This time around, my timing was off. I ran out of T on December 4. I got a smaller dose than normal and I haven’t been able to buy more since. I’ve now missed two shots, it will be three as of this Wednesday. (I inject every 2 weeks.) Word on the street is that Delatestryl may be back on the shelves this week, and I’ve heard mumblings that Depo is back in stock already, so I’ll check with my pharmacist.
What To Do When There’s a Testosterone Shortage
The best way to ward off the effects of a shortage is to not let yourself run out of T to begin with. It seems like an obvious and wise plan indeed to always keep a backup vial around. Given that I only go through four vials of T a year, keeping one spare around won’t raise any red flags with my doctor. The obstacle for me is that I don’t have convenient and regular access to a pharmacy. I live an hour from any pharmacy, and I combine chores into a single “town day” every couple of weeks. I can’t just pop in and pick up my T like I could if I lived in the city. It’s really just a matter of advance planning though.
Here are some of the suggestions that I’ve seen bandied around for averting this most recent Delatestryl shortage:
- Switch to Depo. Normally this would be the ticket but the concurrent Depo shortage made this a moot point.
- Get injectable T compounded. Only certain compounding pharmacies can do this, they need the right facilities (namely, a sterile hood.) This is probably a pretty good option if you have access to such a pharmacy and if you’re willing to spend a bit more.
- Check with your local trans health clinic. If you have access to such a clinic, you may find that they keep their own stock of T on hand and can give you a shot. For example, the Three Bridges Community Health Centre in Vancouver will do this (provided you have an existing Rx.)
- Switch to Androgel. My understanding is that many trans men are not satisfied with the effects of T gel, but this could be a good stop gap solution provided getting a new Rx from your doctor isn’t a big hassle and you’re OK with the higher expense of gel.
- Cross the border. Legally speaking, you can import testosterone into Canada as long as you have a valid prescription and physically carry it across the border. However, I don’t see this as a valid option given the expense of time and money.
- Get T from a friend. I wouldn’t do this for legal reasons and because I think it could damage the trust that my doctor has in me.
- Underground labs.This is a dumb idea, don’t do it. Not only is it illegal, and something your doctor would seriously frown upon, you’re likely to get something that’s cut or something that’s not T at all. See: Don’t Be Silly: A Public Service Announcement on HRT.
- Patience.
I opted for the latter, patience. I’ve looked at this outage as a cleanse of sorts. Granted, I feel I have the luxury of this choice because I have a few years of T in me and I’ve had a hysterectomy. Were I earlier in transition, or pre-hysto, these shortages would cause me significant anxiety.
What It’s Like Being Off Testosterone
It’s been almost 6 weeks since my last (short) shot of T. I’m thoroughly surprised that my energy levels and mood seem unchanged. I haven’t been without symptoms of hormonal flux though:
Within a week of being late for a shot, my dick shriveled to about half its size. It doesn’t get hard and I have zero sex drive. I’m confident that this will all return to normal once I’m back on the juice but it’s another nail in the coffin for Metoidioplasty for me.
Hot flashes, oh my! They’ve consistently increased to the point where I’m having several an hour. I’m constantly taking off my shirt, or putting it back on. In retrospect, I think I was having (much less frequent) hot flashes prior to running out of T and this makes me wonder if my dosage is correct.
I’m having more headaches, and I think it’s hormonal, but I can’t really be certain.
It’s been over a year since I’ve had blood work done so I plan on arranging that once I’ve been back on T for 8 weeks or so. As I mentioned earlier, I’m going through exactly four vials of T a year (a total expense of $625.79 since April 2008.) For most of 2011, I was on a reduced dose between 160-180 mg by choice, but given the incidence of hot flashes that I was having even before this recent shortage, I’m considering going back to 190 or 200mg. I like the idea of injecting as little as I can get away with, but without sacrificing health or well-being.
In the end, testosterone shortages are a problem for Canadian trans men, but luckily full outages aren’t that common. While I certainly prefer having an uninterrupted supply of my medication, it’s good to know how my body responds without testosterone and that I don’t fall into low energy and bad moods without it.
UPDATE, 01/16/12 – Related Links:
- Current Drug Shortages + Bulletin – Shows T. Cypionate returning to the US in early Feb 2012
- Worldwide testosterone shortage??? – Forum thread about recent Sustanon and Primoteston shortages
UPDATE, 01/18/12:
My local pharmacies still can’t get any injectable testosterone in for me. My headaches and hot flashes are increasing in frequency and intensity, and I’m feeling pretty weak (my workout this morning was lame.) I guess my limit for being off T is about 4 weeks. I considered calling the doctor and requesting a prescription for Androgel, but I just got a hold of a pharmacy in the next town over who happen to have a single 10ml vial of Sandoz-made Cypionate. YES!
* I’m a bit surprised by this because I didn’t know we could get Sandoz brand T in Canada. The pharmacist noted that Sandoz is also out of stock so she can’t order more if it. She put my name on the bottle, my doc’s calling my prescription in tonight, and I can pick it up on Friday. Just a couple more uncomfortable days…
We here in Australia have had sustanon shortage / outage since about sept or so… Luckily being in a large city there is access to other options.
Thanks for sharing that, Alex. I think Benjamin discovered through his inquiries that one of the cogs in the manufacturing delay was a lack of the carrier oils. If that’s the case, then I imagine shortages could spill beyond national borders. Good to hear you have alternatives!
I feel you — I’m on Nebido (similar to Reandron) and I just found out that they’re not importing it anymore (at least for now). It’s scary to be dependent on a drug and know that you could lose access to it for whatever reason: personal financial issues, loss of insurance, corporate policies, importation policies…
Like Alex, I was able to switch to an alternative form of T. I hope you can fill your prescription soon — hot flashes don’t sound like fun.
Interesting, I’ve heard of Nebido. What are your other options in Argentina?
Yes, the hot flashes are annoying. They sneak up fast. Thankfully I can be topless at anytime, I’m not bound by public workplace etiquette and such.
I sure hope you achieve a stable supply again. Your suggestions for keeping a small reserve supply and knowing what might be expected during lean times should prove helpful. I’m a non-trans guy using therapeutic T. I was using Phizer brand Depo-Testosterone for several months. In the U.S. I believe it’s typically supplied at a concentration of 200 mg/mL dissolved in cottonseed oil. Personally, I haven’t experienced much benefit from the HRT. It’s clear to me that trans folks are likely to find HRT to be far more beneficial.
I’m confident the supply will return to normal in short order. Interesting that Pfizer makes a 200mg/ml preparation in the US but not here. Maybe there’s some kind of competitive arrangement / production licensing that prevents them from making Depo-T in the same concentration as Delatestryl. Otherwise, the only people who’d buy Delatestryl at its higher price would be those who have allergic reactions to cottonseed oil.
Thanks for this excellent post. It’s the most informative piece I’ve read about this issue so far and I’ve reposted it on my Facebook page.
As I said in a previous reply, I just got a new prescription for Depo to replace Delatestryl, which is out of stock in Montreal. I was surprised to find out, as you mentioned, that I need to inject twice the volume with this one. I will see in a few minutes what this feels like.
I will probably feel a bit better about potential shortages after my hysterectomy, but as I am still in my first year of T, here’s hoping they will be few and far better. I wish we had more options here in Canada, although I find the subcutaneous injections quite easy to manage.
Keep up the good work!
Thanks Damien! How was the bigger shot? I’m especially curious because you’re doing sub-Q—as most guys in Montreal do. (Which makes sub-Q a witty abbrev., as in QUEBEC.)
I didn’t notice a difference with the larger IM injection, though I assumed I might have more pain in my leg. Pain seems to be mostly associated with injection technique though. When my technique is good, no pain. Sometimes it’s not as good and I have muscle pain for a couple of days. I moved down to a 23 gauge needle (from a 22) and am taking Arnica when I do my shot, in an effort to minimize this. (I also warm my T up slightly.)
Thanks for asking! The shot was fine. The higher volume seemed daunting, but the injection went well. I did have a slight bump and some irritation afterwards, but this has happened occasionally with enanthate as well. Except for that, I feel the same as with enanthate. I had to inject a day earlier than usual because I am having surgery next week on Tuesday, so am switching to Mondays, but again, it was not a problem. I also warm my vial of T in my hand for 3-4 minutes before injecting, as my nurse instructed me.
I’m glad to hear that from this current 6+ week experience being off of T, you realize that your dose may have been incorrect. So I hope that once the outage is resolved you can adjust your dose and return to well being and good health quicker.
This Sustanon shortage is definitely worldwide – people in the Americas, Australia, NZ and Europe are having problems getting hold of any. Apparently, it’s something to do with licencing – the Organon company is having trouble getting its licence renewed so it’s not allowed to sell any more Sustanon until it does. This has been going on for months now.
Luckily, there’s alternatives – the Bayer company still has its licence so everyone can still get Nebido, Testogel and (Bayer-produced) Enanthate. Not sure if that’s just in Europe though. I’ve heard Nebido/Testogel aren’t available in the Americas.
Nebido is available in Argentina, at least, and probably throughout Latin America (though I’m not sure). It was never approved in the US; I’ve read rumors that the disapproval was due to political/business reasons (it would be too competitive or something), but I haven’t seen any solid facts.
I don’t know about Testogel (the brand), but I think gel is available pretty much anywhere. I know that many pharmacies and local pharmaceutical companies can produce it.
I love Nebido (on of the brand-names for testosterone undecanoate) because you can inject it every 12-14 weeks. You only have to inject it a few times a year and then you can forget about it for several months (you can even go on a long vacation without worrying about vials and syringes). I was afraid of getting huge peaks and troughs, but apparently it’s very well-made and manages to keep uniform levels of T. Too bad I can’t get it anymore 😦
My other options in Argentina are similar to everything you guys have been listing: enanthate/cypionate injections and gel. I’ve used gel for a while because it costs the same as the injections (not because gel is cheap over here, but because all forms of T are really expensive). An odd difference is that injections come in tiny, single-dose vials. Also, testosterone isn’t a controlled substance! You don’t need a prescription, though most guys I know still go to an endocrinologist to get one (a very mature decision).
@genderkid I remember hearing that Nebido (or was it Sustanon?) was under some kind of review for North American approval. That was over a year ago to my mind, so from the sounds of your comments, that got denied. As you say, surely for some kind of protectionist/non-competitive policy. The long half life of Nebido is quite appealing. It’s also interesting to hear about other differences in Argentina: the high expense of T, the small one dose vials, and that it’s over the counter. Thank you!
Not trans, but lacking the ability to produce my own testosterone so I have spent a decade on Delatestryl and I do go through a vial in five weeks as I seem to metabolize the T rathe quickly, I get 200mg/week to keep me “at level”.
Anyway, I have been on reduced dosages since November and as of last week I am out. For me that’s mostly a mental effect right now and the biological ones will take a while longer, outside of the sex drive being gone.
I did submit the story about the shortage to the CBC’s “The Current” as a story idea. For me the lack of T is mostly quality of life and I can cope with it for a few months if I must. But for Trans people I suspect the effects are much more pronounced and the more this gets into the mainstream media, the better.
Thanks you Michael, your non-trans perspective is valuable in this conversation. I’m fascinated by how different “factories” (bodies) metabolize T differently.
The week after writing this blog post was pretty uncomfortable for me, with a lot of headaches and hot flashes. It made me realize just how essential this medication is to my body. I’ve gotten two shots into me over the past few weeks and I’m starting to feel much better.
So, it’s still not available. I certainly think that’s worthy of a mainstream news story, good idea on the submission. (And it wouldn’t surprise me if there’s at least one guy on The Current staff who’s on T and who could relate.)
Yeah for me the main concern is more about people around me. GF is not “happy” right now because sex is off the table, but it’s really not something I have any control over.
My main concern is more the mental kind. Lack of it tends to bring on depression at varying degrees, it sure will be interesting.
On the other hand it puzzles my mind how this can go unnoticed / uncared for by the Provincial Health Authorities, you’d figure they would get involved, though so far it seems they have no clue / don’t care.
Noticing that my last vial of Delatestryl was running low last week, I cracked open the phone book and called every pharmacy in the city looking for more T. I think I managed to get the last vial in the area, from a small town 15 minutes away. The pharmacist called SaskHealth to see if he could get any more information. They said they had no idea when Delatestryl would be back. The brand I got, Sandoz tesoterone cypionate, should be back sometime in May. They also said that there should be testosterone cypionate available from a different manufacturer (didn’t get the name) sometime mid-February.
I was discussing this with someone today and they had also heard that another brand should be available pretty quick – I’ll ask what the name is, and try to contact them for more information. In my opinion SaskHealth doesn’t always seem to know what they’re talking about, but fingers crossed on this one.
Thanks for the update, Rayden. Interesting, Delatestryl was supposed to be back mid-January! And while the shortage has affected brands in the US, both Sandoz and Pfizer are still available south of the border. Pfizer is the other brand your pharmacist was probably talking about, and I’d heard of a mid-Feb return to market for that brand. We shall see…
@Michael You’re right, it’s puzzling. I get different information depending on which pharmacy I call. I’m encouraged by Rayden’s recent update here though. A mid-Feb ETA for Pfizer cypionate would be great.
Joshua, thanks very much for your information about the shortages and about the differences between the delatestryl and the depo. I just found out about all this last week when I went to reorder my husband’s prescription – he’s been on delatestryl for nearly a year – and was told it would be indefinitely unavailable. Very upsetting for him and for everyone who is dealing with this, of course. No idea this could even happen … yikes. We’re exploring his options now, and very much appreciate the details you’ve provided here.
Tricia, I’m glad this info was helpful! Delatestryl “indefinitely unavailable.” Wow, huh? With little hope of it coming back to the shelves any time soon, and with Sandoz shutting down production, we have one option left in Canada: Pfizer’s Depo-T. It could be back by mid-March.
The good news is that your husband probably won’t notice ANY difference between Depo-T and Delatestryl, other than a bigger shot and lower cost. The best bet for finding a vial is to call every pharmacy in the book to locate one with T still in stock. You may even have to look out of town, I did.
ps. Have we met? Gender Odyssey 2009?
I’m really glad to hear he probably won’t notice a difference. He’s been calling every pharmacy around and is on a couple of waiting lists for the Depo.
And yes, we did meet then, which was delightful!
Yes, he shouldn’t any difference in terms of the effect of the T, though it’s true that some guys have allergies or skin reactions to the cottonseed oil in Depo. I haven’t noticed this myself. However, it got me thinking about cotton and the fact that it’s a highly genetically modified crop. ApotheCure in Dallas, TX is the only compounding pharmacy I’ve heard of that will formulate injectable testosterone in olive oil. I haven’t had any luck finding a compounding pharmacy in BC that can make injectable T yet. I wish we had mail order access like ApotheCure or Strohecker’s in the US. Better yet, I wish we had access to sub-cutaneous testosterone pellets in Canada.
For anyone on Vancouver Island, I know a pharmacy that has lot’s of testosterone cypionate. The pharmacist foresaw the shortage coming and stocked up on Pfizer brand and he has lots more coming in. Of course, since it is illegal to advertise drugs, he can’t get the info out. PM me for details.
Oh, I should mention that anyone on androgel paying the ridiculous prices fior a product THAT DOES NOT WORK (suspending the T in alcohol is useless according to experts, and will NOT absorb), there’s a compounding pharmacy in Nanaimo that will provide you 3 months supply of generic androgel using a substance with DOUBLE the absorption rate of alcohol based Solvay product for $110!! 3 months supply for $110!!
Thanks for this helpful information, Timmy!! A pharmacist who saw this coming and stocked up… wow. He’s a keeper! However, the statement that he has “lots more coming in” is probably a bit inaccurate. I’ve been told that all BC pharmacists use the same distributor for testosterone, Mckesson, and they don’t have any Depo-T to sell. Your pharmacist may have a lot of it on order, but it’s not going to come in until Pfizer gets it out the door, which according to an advisory from earlier this week, could be by Feb 29. Also, your pharmacist may be restricted from “advertising drugs” but there’s nothing illegal about you publicly stating the name of a pharmacy with T in stock. (No one reading your comments here can PM you because your email address is not published with your comments.)
Also, super interesting information about Androgel, I’d never heard that before but it would help explain why so many trans guys find it less effective than injections. Weird though, there are now SIX testosterone gels on the market in the US, and the T from those won’t absorb properly? Ridiculous. It’s being majorly marketed to low T men… Cha-ching!
Ok, I didn’t post specific info because I wanted to make sure it was okay with you forst – it’s your website, your rules and I want to be respectful. Ok, so the pharmacy with the Pfizer Depot-T is Central Drugs in Lantzville, a sleepy little seaside village just north of Nanaimo. $44 for a 10ml vial, 100mg per ml. He tells me he has lots in stock and shortages won’t be a problem as he foreseen the shortage and has lots in reserve as well.
As for the compound pharmacy, it is Central Drugs on Bowen Road in Nanaimo. Kevin, the compound pharmacist will take your Androgel script, whip up a 3 month supply of versa based test cream to be ready the next day for a cost of $110! Consider, a one month supply of Solvay Androgel from Wal-Mart cost approx $140. Kevin showed me graphs which demonstrated that the versa cream has DOUBLE the aborption rate of alcohol based Androgel. He said that he has had customers using Androgel for over 6 months and their T levels never budged, yet when they tried the compounded product, within 3 months they had to have their dosage reduced as their T levels went off the charts! He gave me a demonstration on how to use the product, made sure I absorbed it properly, and monitored for allergic reaction – there was none. Anyhow, hope all this info is helpful to people.
Thank you very much for all this inf, Timmy. I’ve added the relevant parts to this new post: Testosterone Shortage Update: ETAs, Alternatives and Causes. While I was researching that, I came across this info about dosage absorption/excretion:
So either way, if I’m understanding this correctly, most of the medication is NOT used by the body.
I too am presently dealing with the effects given birth (pun not intended) to through this ‘outage’ (intentional no doubt). My need for the drug, Delatestryl, rises from my one time addiction to opiates and though I no longer abuse these type substances (or any for that matter) I am battling my addiction with the assistance/use of methadone (which works to numb the ‘discomforts’ associated with withdrawal) however it itself is also an opiate. Opiates tend to have a rather nasty effect on Testosterone levels, my self not knowing this nor that there existed treatment, i.e. testosterone based solutions, until becoming knowledgeable through conversation with a friend and, being that I was then actively abusing the opiates while on methadone (a common practice amongst ‘using’ addicts although that’s another topic all together) I figured that I may as well have the blood work done for, if nothing else, it may prove to be that some of the ‘symptoms’ I had grown use to (and simply accepted as ‘Me’, i.e. depression, sluggishness etc’ etc’, I’m sure you’re all quite familiar with them, well the underlying hope was that these) could be alleviated. My first test came back with (I believe my Dr’ referred to them as being) pathetically low (testosterone) readings. After 3 months of receiving the common beginners amount of Delatestryl (I don’t recall the amount) I had another round of blood work done to see where my levels stood and not surprisingly they were still quite low. After that (nearly 3 yrs ago now) I received, until recently that is, 2mg @ 2X monthly. Over the last 3 years I recall a few shortages taking place but none of them seemed to have an impact quite as direct as this one has. It’s been between 6-8 weeks now since I’ve had a shot and as of late, say the last few days, I’ve really started to take notice of the absence of the Testosterone leveling compounds in my system. Today for instance I’ve not been able to ‘will’ myself to do anything other than make my way to the bathroom, let the dog in and out (minimally) and take my meds. I’ve not the will or interest to eat, I find myself dwelling on those aspects of my existence that are less than favourable in a manner which leads me to find myself suddenly fighting the swell of tears and gasping for breaths in fight to keep myself from ‘breaking down’ (even now as I think about it my heart pounds in my chest) and needless to say I’ve kept from embarking on those tasks which needed to be seen to today (and those which needed to be seen to days and weeks ago). I’ve not even been able to find the interest in removing my winter boots which I put on (@ 930 am) this morn’ when stepping out to fill my dogs water dish. My head’s pounding, my stomach’s growling, and here I sit (or ‘rot) doing nothing about anything. I’ve encountered this exact ‘realization’ through an absence of my Delatestryl not all that long ago and thankfully it didn’t last too terribly long. This time however may be a different story. I’ve contemplated searching high and low by means of placing phone calls to as many pharmacies as possible in effort to locate Delatestryl which, if I am able to find, my Dr. would then provide the ‘script for me to obtain some, but even though such may very well be the means to an end of my personal drought (and symptoms) actually finding the will and/or energy to do so is a completely different story. It’s brutal, and it may be that few of you are able to understand how it is that such simple ‘every day’ tasks can possibly be that difficult to perform and complete but none of us are perfect, we all have our very own ‘battles’ and obstacles to face, and I simply thought I’d share a little about mine w/ who ever may be interested. Why? Maybe more so for me than anything/anyone else, I don’t know, but if you can’t see that we’re not all created equally nor do we all possess (or want) the ability (or curse) to understand or internalise another man’s/lady’s reality than I would kindly ask that you keep your superior/arrogant/ignorant (whatever it may be) comments to yourself.
I too am presently dealing with the effects given birth (pun not intended) to through this ‘outage’ (intentional no doubt). My need for the drug, Delatestryl, rises from my one time addiction to opiates and though I no longer abuse these type substances (or any for that matter) I am battling my addiction with the assistance/use of methadone (which works to numb the ‘discomforts’ associated with withdrawal) however it itself is also an opiate. Opiates tend to have a rather nasty effect on Testosterone levels, my self not knowing this nor that there existed treatment, i.e. testosterone based solutions, until becoming knowledgeable through conversation with a friend and, being that I was then actively abusing the opiates while on methadone (a common practice amongst ‘using’ addicts although that’s another topic all together) I figured that I may as well have the blood work done for, if nothing else, it may prove to be that some of the ‘symptoms’ I had grown use to (and simply accepted as ‘Me’, i.e. depression, sluggishness etc’ etc’, I’m sure you’re all quite familiar with them, well the underlying hope was that these) could be alleviated. My first test came back with (I believe my Dr’ referred to them as being) pathetically low (testosterone) readings. After 3 months of receiving the common beginners amount of Delatestryl (I don’t recall the amount) I had another round of blood work done to see where my levels stood and not surprisingly they were still quite low. After that (nearly 3 yr’s ago now) I received, until recently that is, 2mg @ 2X monthly. Over the last 3 years I recall a few shortages taking place but none of them seemed to have an impact quite as direct as this one has. It’s been between 6-8 weeks now since I’ve had a shot and as of late, say the last few days, I’ve really started to take notice of the absence of the Testosterone levelling compounds in my system. Today for instance I’ve not been able to ‘will’ myself to do anything other than make my way to the bathroom, let the dog in and out (minimally) and take my meds. I’ve not the will or interest to eat, I find myself dwelling on those aspects of my existence that are less than favourable in a manner which leads me to find myself suddenly fighting the swell of tears and gasping for breaths in fight to keep myself from ‘breaking down’ (even now as I think about it my heart pounds in my chest) and needless to say I’ve kept from embarking on those tasks which needed to be seen to today (and those which needed to be seen to days and weeks ago). I’ve not even been able to find the interest in removing my winter boots which I put on (@ 930 am) this morn’ when stepping out to fill my dogs water dish. My head’s pounding, my stomach’s growling, and here I sit (or ‘rot) doing nothing about anything. I’ve encountered this exact ‘realization’ through an absence of my Delatestryl not all that long ago and thankfully it didn’t last too terribly long. This time however may be a different story. I’ve contemplated searching high and low by means of placing phone calls to as many pharmacies as possible in effort to locate Delatestryl which, if I am able to find, my Dr. would then provide the ‘script for me to obtain some, but even though such may very well be the means to an end of my personal drought (and symptoms) actually finding the will and/or energy to do so is a completely different story. It’s brutal, and it may be that few of you are able to understand how it is that such simple ‘every day’ tasks can possibly be that difficult to perform and complete but none of us are perfect, we all have our very own ‘battles’ and obstacles to face, and I simply thought I’d share a little about mine w/ who ever may be interested. Why? Maybe more so for me than anything/anyone else, I don’t know, but if you can’t see that we’re not all created equally nor do we all possess (or want) the ability (or curse) to understand or internalise another mans/lady’s reality than I would kindly ask that you keep your superior/arrogant/ignorant (whatever it may be) comments to yourself.
Checked with Pharmacy (Shoppers) a week ago. They now have Delatestryl but not Depo, and they think it may be up to a year before Sandoz comes back on line because of their compounded problems (the last being mislabeled drugs… after their FDA inspection failure and plant fire). Depo is the government approved testosterone Rx, having reached an agreement on that supplier because of cost. Now Sandoz is not available (hopefully temporarily), it’s worth it for Canadian transguys to apply for a special authorization based on non availability of the approved drug. It’s even worth it to push f or that authorization, even in press, if rejected. Pharmacare has the ability to be more flexible but only usually responds to public scrutiny and medical necessity demand.
I managed to order Pfizer Depo on April 17. I will avoid Delatestryl as long as possible because I don’t like being jerked around. I’d never even seen Sandoz Depo until I managed to find an old vial during the recent shortage, but it’s unsettling that options have dwindled to just two brands of injectable T in Canada, especially since compounded T is more expensive and more difficult to source.
I’m not clear on what a special authorization would permit me to do. Can you clarify that?
This is the first time ive heard of a shortage, Im visiting Canada as i make this reply, seriously hadn’t any knowledge of any shortage of any kind here. This must be very frustrating to no end and i feel all of your pains, truly, Im visiting here in Canada till next month, Ive been on “T” for bout 3 years now, though i do not use any injectable T, i do utilize a daily cream of T instead to keep my body on a steady level, Im from Hawaii, and deal with rising costs as well, i do have my compund made in Arizona and have it shipped to me in Hawaii which comes out to be a 60 day supply with shipping 52.00 american dollars, this hormone compounding pharmacy is very doable for us in the states and even more so for many who are on “T” regardless of being Trans or not in Hawaii. Lmk if shipping from United States to Canada is a problem if not this may be another alternative for everyone in Canada. I do not know of the rules and regulations here as you do, but if i could be of any help from this side of the border i’d be glad too.
Thanks for your comments, JK. Drug shortages are a growing reality, unfortunately. Compounding pharmacies are available in Canada, though they seem more expensive than US ones. Even with a prescription though, it’s illegal to import controlled substances like T across the border. Enjoy the rest of your trip!