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WHAT WE TREAT
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What we treat
Hair Loss Treatment

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Testosterone Replacement

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Trt


LIFE-CHANGING TREATMENT FOR LOW TESTOSTERONE

Feel healthier, happier and stronger with a tailored testosterone treatment plan
designed by our expert TRT doctors.

Find out moreBuy a blood test
90%
of  patients reported improvement in symptoms within 3 months
Tom, 34
Improved energy
Better mood
Mark, 36
Improved energy
Better focus
Antony, 64
Improved fitness
Better mood
Ali, 34
Improved sex drive
Better sleep


TrustScore 4.6/5 • 675 reviews


THE HORMONE THAT’S HOLDING MEN BACK

Dr. Chris Airey, TRT Expert


1 IN 4 MEN SUFFER FROM LOW TESTOSTERONE¹

After the age of 40, testosterone levels start to decline by 1 to 2% on average
each year.²


90% OF MEN IN THE UK REMAIN UNDIAGNOSED³

Too many men are suffering from the life-altering symptoms of this
under-diagnosed condition.


LOW-T SYMPTOMS CAN TAKE THE JOY OUT OF LIFE

Low mood/anxiety

Low sex drive

Low muscle mass

Lack of focus

Low energy

Weight gain

Erectile dysfunction

Poor sleep quality

CITATIONS

¹ The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1
November 2007, Pages 4241–4247
² Generational decline in testosterone levels observed
³ Testosterone deficiency in adults and corresponding treatment patterns across
the globe.

Check your symptomsLearn more about symptoms


WITH TREATMENT YOU FEEL LIKE YOURSELF AGAIN

We’ve helped thousands of patients up their T-levels and transform their lives.
Our patients and their loved ones really noticed the results.


90%
of patients saw an improvement in their symptoms after 3 months
+239%
average increase in Total Testosterone levels among patients over 3 months
79%
of patients an increase in their enjoyment of life after 6 months
87%
of patients saw an improvement in their Libido after 6 months
86%
of patients saw an improvement in their energy levels after 3 months
76%
of patients saw an improvement in their physical ability after 3 months
90%
of patients were satisfied with the treatment they received

CITATIONS

Based on data on MANUAL clinical care data of over 2000 patients over the last
18 months


CLINICALLY PROVEN TREATMENT

Dr. Chris Airey, TRT Expert


We’ll help you get your testosterone levels back within a normal, healthy range.
Our TRT service has research-backed benefits to your health and wellbeing. The
results can be life-changing.

Better mood


Look forward to more good days. Studies show that patients feel more energetic,
friendlier, less irritable and generally in a better mood after starting TRT.¹

Higher Sex Drive


Testosterone can help you get your mojo back. Numerous studies show that
increasing testosterone levels can enhance sex drive, improve erectile function
and increase overall sexual satisfaction.²

Increased Muscle


Testosterone has a bit of a reputation for building muscle and strength. Studies
show that increasing testosterone levels stimulates muscle protein synthesis and
enhances muscle mass.³

Better Sleep


Say goodnight to insomnia and look forward to sleeping soundly. Studies show
that patients who had testosterone replacement therapy reported significant
improvements in their sleep quality.⁴

Improved Memory


Testosterone can help you feel sharper and boost your memory. Studies show that
increasing testosterone levels can significantly improve overall cognitive
function in older men with low-T.⁵

CITATIONS

¹ Testosterone and Mood Improvement

2 Testosterone and Sexual Function

3 https://pubmed.ncbi.nlm.nih.gov/8855787/

4 Testosterone and Sleep Quality

5 Testosterone and Cognitive Function

Testimonials


WE’VE HELPED THOUSANDS OF MEN WITH LOW TESTOSTERONE

TrustScore 4.6/5

675 reviews

Anthony
64 years old

Once I started on TRT, it was a big change in my life. My energy and physical
fitness has improved. I work out 6 days a week and feel good in myself. The team
provided support and guidance throughout my journey at an affordable price.

More Energy
Improved physical fitness
Read Anthony's story

Before treatment

3 months after treatment

220%
increase in Free Testosterone
Danny
42 years old

TRT helped me improve my energy, mood, and overall well-being. It has helped me
sort out my diet, exercise, better routine and better sleep, resulting in a more
positive attitude and better relationships at work and at home.

More Energy
Improved mood
Read Danny's story

Before treatment

3 months after treatment

220%
increase in Free Testosterone
Richard
53 years old

Low energy and brain fog were the two biggest symptoms I had. Then I found TRT.
It’s helped me improve my energy, mental clarity, and overall well-being. I was
able to achieve my goals and gain muscle, lose body fat, and improve sports
performance.

More Energy
More muscle mass
Read Richard's story

Before treatment

3 months after treatment

220%
increase in Free Testosterone
Carl
60 years old

After starting TRT, I felt more like myself again. I was able to regain interest
in things I used to enjoy, and was able to accomplish things that I would never
have done before like building a new kitchen at home!

More Energy
Improved physical fitness
Read Carl's story

Before treatment

3 months after treatment

417%
increase in Free Testosterone

Read our reviews
1
Today
At-home Testosterone test

Start with a simple at-home finger-prick blood test which measures your total
and free testosterone levels. You’ll get your results in as little as 48 hours.

Testosterone & Free Testosterone checked

Easy at-home finger-prick collection

Expert validated report

Analysed at UKAS certified laboratories
Get started for £33.95

2 weeks
Enhanced Testosterone test

A comprehensive venous blood test is needed to confirm the initial result, learn
more about your health, and assess whether it’s safe to start treatment.

Venous collection by a nurse

Checks liver, kidney & PSA levels to make sure you’re suitable for treatment

Analysed at UKAS certified laboratories
2
Within 4 weeks
Speak to a specialist Doctor

Discuss your blood test results, symptoms, medical history, treatment options
(including costs), and monitoring process with an expert TRT doctor.

Video consultation

Private and confidential

Qualified TRT experts

Analysed at UKAS certified laboratories
3
4 weeks
Start your treatment

Your doctor will design a personalised treatment plan that’s tailored to your
lifestyle. It may include medication, lifestyle advice or supplements.

Analysed at UKAS certified laboratories
4
On going
Testosterone monitoring and plan adjustments

We’ll test your blood at 6 weeks, 3 months, 6 months, and 12 months after to
allow your doctor to effectively monitor your progress and make any adjustments.

Analysed at UKAS certified laboratories
5

Our pricing
Take a closer look at our pricing structure to understand the cost of your
customised treatment plan.
Learn about pricing
THE PROCESS
THE PROCESS


HOW TO START TREATMENT

Get Started


A TREATMENT PLAN TAILORED
FOR YOU

As part of our TRT service, you’ll receive a comprehensive diagnosis and a
bespoke treatment plan that may include medication, lifestyle advice or
supplements.

Learn about TRT treatments
Injectable
Effectiveness

High

Format

Injections two or three times weekly for most patients

Results in

1-3 weeks

Oral
Effectiveness

Moderate

Format

Tablet taken once daily
‍

Results in

3-8 weeks

Topical
Effectiveness

Individual

Format

Apply to the shoulders or arms once a day

Results in

1-6 weeks


LED BY TRT EXPERTS

“We offer the most effective protocols in formats to suit your preference”

Learn about TRT treatments


SPECIALIST CARE ON YOUR TERMS

What you get

Convenient and online
Quick diagnosis and treatment
Doctors who specialise in TRT
Gold-standard treatment plans
Monitoring & treatment adjustment


Manual



NHS



Team


MEET OUR TRT EXPERTS

We have the UK’s leading TRT experts on board, so you know you’re in good hands.




DR. CHRIS AIREY

TRT Medical Expert
Read Bio


DR. LOUIS CHOO

TRT Medical Expert
Read Bio


DR. ZAK TAYLOR

TRT Medical Expert
Read Bio


RANA MIRZAI

Clinician, TRT
Read Bio


YOUR QUESTIONS ANSWERED

Our team has a lifetime’s worth of expertise and experience between them.
They’re on hand to answer all of your questions at every stage of your journey.

View all
About TRT
Symptoms
How it works

5 common symptoms of low testosterone
Dr Sheliza Darvesh, GP Clinical Lead
What are the potential benefits of TRT?
Dr Sheliza Darvesh, GP Clinical Lead
What type of people are on TRT?
Dr Earim Chaudry, Medical Director
Is there a discount?
Dr Sheliza Darvesh, GP Clinical Lead
Can I speak to someone about TRT?
Dr Earim Chaudry, Medical Director
Is it legal to purchase TRT online?
Dr Earim Chaudry, Medical Director

FAQ


TESTOSTERONE REPLACEMENT THERAPY

Curated by Dr. Chris Airey, TRT Expert
What is Testosterone Deficiency (TD)?

Low testosterone is a common condition that men can be born with or develop due
to age, stress, disease, physical trauma, an unhealthy lifestyle or
environmental factors.

What are the key symptoms of (TD)?

Men with low testosterone often report low mood, irritability, fatigue, anxiety,
reduced libido or difficulty achieving an erection. Other common symptoms
include brain fog, lack of motivation, low confidence, difficulty losing weight
and difficulty gaining muscle.

How do you test for TD?

Blood testing is the only way to know for sure if you have a testosterone
deficiency. Our Initial Testosterone Blood Test (a simple finger-prick test) can
be taken at home. If the results show that you have low testosterone and you’d
like to start testosterone replacement therapy, UK regulations require you to
take a second, more comprehensive blood test first to ensure that you can safely
start treatment. This one is a venous test which has to be administered by a
nurse or phlebotomist.

How common is TD?

Research has confirmed that testosterone counts in men are significantly lower
than they were just a few decades ago. One in four men over the age of 30 may
have abnormally low testosterone levels according to scientific studies.*

Around the age of 30 testosterone levels naturally begin to decline, but it’s
usually a very gradual process. For most men, testosterone levels drop between
one to two percent each year from the age of 35. Free testosterone levels also
drop considerably as men age, making TD even more common. An increase in
obesity, hormone-disrupting environmental chemicals, and anabolic steroid use is
also making testosterone deficiency in younger men more prevalent than ever.

*The Journal of Clinical Endocrinology & Metabolism

How do TD medications work?

Everyone's medical history is different so our doctor will prescribe a
medication that works specifically for you. Successful hormone therapy involves
getting just the right dose by the right delivery method for your individual
needs. Testosterone replacement therapy involves taking prescribed testosterone
medication in the form of injections, pills, patches, creams, and testosterone
pellets (placed under the skin).

Testosterone injections are the most common form of medication as they are
convenient and most effective for the majority of men.

Is TRT safe and are there any side effects?

Undergoing testosterone replacement therapy is completely safe if you’re treated
by a specialist doctor who regularly monitors your testosterone levels along
with any side effects.

As with all medications, some people may experience side effects - however,
they’re easily controlled and generally avoided with sensible doses and regular
monitoring. Some possible minor side effects include fluid retention, acne, and
increased urination. More severe potential side effects include gynecomastia
(the growth of male breasts), worsening of existing sleep apnea, increased
cholesterol levels, decreased sperm count, infertility, and an increased number
of red blood cells.

Testosterone injections may also increase your risk of certain health problems,
such as heart attack, stroke, blood clots or a worsening of pre-existing
prostate tumours or benign prostatic hyperplasia (enlarged prostate). However,
these side effects can be mostly avoided or controlled through regular
monitoring and other medications.

In order to keep side effects to a minimum you’ll check in to monitor your
testosterone levels and any potential side effects. If you have any concerns or
questions, get in touch with our clinicians - it’s free!


Will I be able to talk to a licensed doctor?

Yes, you willl have a consultation with one of our doctors to discuss your test
results and they can provide a personalised treatment plan tailored to your
needs. Our doctors specialise in TRT for men and are all registered with the
General Medical Council.

Is it legal to purchase testosterone therapy online?

It is legal to purchase TRT online in the UK when buying through a private
clinic such as MANUAL.

Is TRT appropriate for professional athletes?

The World Anti-Doping Agency classifies testosterone as a prohibited substance,
so unfortunately athletes who compete in regulated competitions cannot undergo
Testosterone Replacement Therapy.

How do these blood tests lead to treatment?

Our initial blood test will establish whether you have a testosterone
deficiency. If the first test shows that you have low testosterone you’ll need
to take our second, more comprehensive blood test if you’d like to start TRT -
this is due to UK regulations. If both tests show that you have low T levels,
you’ll discuss suitable treatment options with one of our doctors and during an
in-depth consultation before starting treatment.

How soon will the test arrive?

Our blood test kits usually arrive within three working days. It may take longer
over public holidays.

When will I get my results?

We’ll get in touch to give you your results within two to three business days.
One of our TRT specialists will then walk you through the results, provide
advice, and answer all of your questions.

ARTICLES


LEARN MORE ABOUT TESTOSTERONE



Testosterone Replacement


SYMPTOMS OF LOW TESTOSTERONE

Dr Earim Chaudry, Medical Director


Testosterone Replacement


BENEFITS OF TRT

Dr Earim Chaudry, Medical Director


Testosterone Replacement


NORMAL MALE TESTOSTERONE LEVELS

Dr Earim Chaudry, Medical Director


Testosterone Replacement


WHAT IS TRT

Dr Earim Chaudry, Medical Director


Testosterone Replacement


IS LOW SEX DRIVE COMMON IN MEN?

Dr Earim Chaudry, Medical Director




HAVE A QUESTION?

Whatever it is, get in touch:

0207 427 6085

Mon-Fri 9:00-17:30

help@manual.co

We aim to reply in 24hrs

Email us

We aim to reply in 24hrs

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Superintendent Pharmacist
Anish Devji Bhalsod
GPhC Registration: 2086847
‍
Copyright 2023 Manual™. All rights reserved.



DR. CHRIS AIREY

Dr. Chris Airey is a medical professional known for his expertise and
contributions in the field of hormone replacement therapy (HRT) and functional
medicine.


BACKGROUND

Dr Chris Airey BMBS MMedSc Dip ENDO, is a fully registered doctor with the GMC
(General Medical Council) and Care Quality Council (CQC) in the UK, with
extensive experience in testosterone replacement therapy.

He trained at The University Hospital Southampton and went on to graduate as a
doctor with a joint Bachelor of Medicine and Bachelor of Surgery plus a masters
degree in Medical Sciences, completing his research project in the Medical
Neurosciences Department. He holds a post-graduate diploma in Endocrinology with
the University of South Wales.

Dr Chris is a Member of the Endocrine Society, European Society for Sexual
Medicine, and the Androgen Society.

Qualifications

BMBS MMedSc Dip ENDO, is a fully registered doctor with the GMC and CQC
Start Consultation


DR. CHRIS AIREY

Dr Louis Choo is a practising GP with a special interest in men’s health.

Background

After completing his medical degree in Imperial College London in 2016, Dr Louis
Choo completed postgraduate training across hospitals in England, gaining
experience in a wide range of settings, specialties and working with a diverse
range of patients.
‍
Dr Louis Choo is passionate about quality improvement and has represented
doctors on multiple committees. Prior to joining MANUAL, Dr Louis Choo held a
committee position in NICE and contributed to developing national policy
assessing the clinical and cost effectiveness of new treatments and
technologies.

As a GP, Dr Louis Choo is all too aware of the importance of lifestyle advice,
an often neglected aspect of modern medicine, and uses every opportunity to
encourage and motivate his patients to make consistent, meaningful changes to
achieve their goals.

Qualifications

MBBS BSc MRCGP (2022)
Start Consultation


DR. ZAK TAYLOR

Zak Taylor is a fully GMC registered doctor and psychiatrist with a special
interest in men's health, addiction and mental health.

Background

Dr Taylor graduated from Southampton University and has been practising medicine
since 2014. He is passionate about endocrinology and worked in this field before
transferring specialties to become a specialist psychiatrist. He has a wealth of
knowledge and experience across all areas of psychiatry but understands the
important relationship between the role of endocrinology and lifestyle
modifications, and how this can impact both physical and mental health.

Dr Zak is a specialist in addiction psychiatry and understands the correlation
between long term opiate use and how this affects the endocrine system. Away
from his role with Manual, Dr Zak provides specialist addiction treatment for
those who have failed to achieve abstinence or get the relevant support through
NHS services. 

Dr Taylor has been supporting men with their health and helping to manage their
TRT for over 4 years. He is passionate to see his patients take control of their
own physical and mental health and is a strong advocate for equipping them with
the tools and resources needed to achieve a healthy and hopefully long term
future.

Qualifications

BMBS, BmedSci
Start Consultation


RANA MIRZAI

Specialist Mental Health Pharmacist with experience within the NHS, responsible
for medicines management and optimisation for people with complex mental health
problems, including those with co-morbidities and physical health complications.

Background

Qualified pharmacist with experience expanding through many different
specialities. With 2 years of dedicated experience to the mental health service
(including anxiety, depression, post-traumatic stress disorder, substance or
alcohol abuse, self-harm and suicide prevention).

Thorough knowledge of complex mental health conditions and management strategies
as well as expert knowledge on antidepressants and prescribing for mental health
conditions.

Experience in medicine optimisation and management to make sure you get the most
out of your tailored treatment plan.

Qualifications

MPharm (Masters in Pharmacy)PGDip (Independent Prescriber)
Start Consultation


Start with a testosterone blood test
Start with a test
£33.95
Get started

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