Online TRT Clinics Being Shut Down?

I saw some articles talking about the suspension of the Ryan act being lifted due to the end of the covid emergency. What impact does this have on online TRT since it’s a schedule 3 drug? Has anyone been told their online clinics will stop prescribing this month?

This is unlikely to affect legitimate TRT clinics, but even if it were true, the underground just became more popular putting men and greater risk.

I doesn’t have any. Only CI and CII.

Not true. Just had a meeting with Rick Colins one of the leading attorneys in the United States and it’s going to have a great impact and literally will shut down all of the telemedicine online clinics. They’re going to require an office visit and most of these online clinics do not have a brick-and-mortar building. There’s also talk about restricting testosterone being utilized off label. There’s a lot in the works right now with regard to the DEA because of all these online clinics that are prescribing testosterone, anabolic steroids, growth hormone, and non-FDA approved peptides. There will be significant restrictions on prescribing testosterone in states that a provider does not have a physical presence in.

In fact they’re going to take that away. So online clinics and telemedicine is about to have some major changes in the ability to prescribe testosterone is also going to be affected by possibly restricting it to only those that meet the strict criteria for hypogonadism. It was bound to happen because you just can’t have online clinics prescribing these substances the way they have been. When the DEA comes in they just don’t target the bad they take down the good and the bad at the same time. So restrictions designed to hurt the bad clinics will also have the same effect on the good clinics.

If you can only prescribe testosterone to people that see you in person it’s going to be very restrictive. And even if they do come see you in person in your state it appears that you’re going to be unable to provide them with prescriptions in a state that you’re physically in. So if you have a practice in Alabama and someone comes in to see you for testosterone but they live in North Carolina for instance you won’t be able to send prescriptions to North Carolina. It’s not just having a license in a state it’s having a physical presence. This is how they’re going to stop basically all clinics from doing telemedicine with regard to testosterone. So if you’re using a clinic in Florida presently and you live in Louisiana you will no longer be able to use that clinic in Florida. It’s unfortunate but what happened with the pills and pain management has now happened with hormones

If true this will have a big effect on medication for transgender patients. You made a comment about off label use of androgens in the FDA orange book being banned. Curious about this.

So there will be significant restrictions on telemedicine upcoming. Transgender patients are a different category then how men obtain testosterone. The majority of men that are getting testosterone from these online clinics are men with normal levels of testosterone and therefore it is legally prescribed off label. In order to restrict the abuse of growth hormone they made it illegal to prescribe off label and that cut down the prescriptions from doctors significantly. So what DEA and FDA are looking to potentially do is to restrict testosterones off label use as well. So in order to prescribe it a man must meet the strict criteria for hypogonadism. So the majority of men will no longer be able to get testosterone unless they have true hypogonadism. From what I hear from a couple of colleagues the DEA is already actively involved in investigating a lot of these online clinics. So when the DEA restricts telemedicine and makes it where you can only provide testosterone to men that you actually see in person and that live in your state it will restrict testosterone’s use. Whenever can’t be used off label it will even more significantly limit its use. So no different as I said than the pill mills were with pain management these testosterone mills have ruined it for everyone.

So what you have provided is what mainstream medicine thinks should happen. They think testosterone should only be utilized for men with low levels that have symptoms. How testosterone is being provided to these men with normal levels is because it’s legal to prescribe every medication except for growth hormone off label. So yes it is FDA approved for men who have low levels and symptoms but it is legal to prescribe any drug other than growth hormone off label. Off label use is the prescription of a medication for a non-FDA approved purpose. Medication can be used off label as long as there is adequate medical literature in peer reviewed journals to support that use. If there is not adequate medical literature then a medication cannot be used off label. So there are plenty of articles on testosterone improving depression, fatigue, erectile dysfunction, libido, etc. So the easiest way for the DEA and FDA to put an end to the testosterone abuse that is going on presently is to restrict off label use and that is what they’re looking to do. I hope this explains it fairly well

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I guess it depends on your sources then.

There are two senators looking to make testosterone unscheduled,

It is the government, nothing is going to happen soon.


That’s the problem, it’s too stick and a good number of men suffering from low-T are left out in the cold. There’s one number for everyone, imagine a shoe store with only one size.

Then alcohol and sugar should suffer the same fate.

Will this effect patients of in-person clinics who do not have hypogonadism or are within "normal
test range ?

It’s not just about the actual hormone level, it’s the medical conditions which make testosterone less effective, like resistance at the cellular level, CAG repeats lengths, long/short. Some guys have symptoms at midrange, it’s normal, but for who, everyone?

We are clones of the same person?

It was Dr. Abraham Morgentaler, an expert in testosterone, an international, world renowned leading figure in the world of testosterone, who said the normal ranges aren’t that useful for determining normal for an individual.

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If they make it where it can’t be prescribed off label it means that no one can get it that doesn’t meet criteria for hypogonadism which would mean you would have to test less than 264 ng/dL on 2 morning fasted tests

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That didn’t answer his question at all. If they make testosterone illegal to prescribe off label like they have growth hormone then you cannot prescribe testosterone unless they meet criteria for the diagnosis. So they would have to meet the criteria for the diagnosis of hypogonadism in order for it to be prescribed. They have to have symptoms as well as low levels of testosterone on 2 morning fasted tests

Unfortunately testosterone is a control substance and it’s being abused quite significantly in this country and others. You cannot deny that these online testosterone mills are ruining it for everyone. I’ll say it again they came in and regulated the pain management pill mills and they will do the same to these testosterone clinics. But when they do this to the bad clinics it will have the same effect on the good clinics and that will be that it will limit who can get testosterone prescriptions

You’re wrong about that. They’re about to come down on telemedicine. That’s gonna happen. Everyone at WorldLink medical just got an hour long lecture from an attorney letting everyone know what’s about to happen. So in New York testosterone is a C2 drug. Hawaii just made it where a physician outside of their state can’t prescribe testosterone. Oh there are a lot of changes happening and it will be sooner than later

I don’t know anything. All I’m doing is reporting what I’ve been told. I also saw the WorldLink webinar.

This somewhat reminds me of when the HIPAA laws were enacted and attorneys were going around scaring everyone thinking they were going to end up in HIPAA Prison if they don’t hire them as consultants to lawsuit proof their practice. Same for Medicare regulations and requirements.

I also have two patients who work for the DEA providing information to me. One said it would end up like Prohibition. The thought is this won’t happen for multiple reasons, some related to revenue. I have my own ideas, which are worthless so I’ll keep them to myself. I guess we’ll find out more eventually.

There is a toxic masculinity culture out there these days so who knows? There will be a lot of unhappy patients here.


Here’s what I’ve been able to find online:

  1. Telemedicine Controlled Substances and Ryan Haight Act
    During the PHE, the Drug Enforcement Agency (DEA) acted swiftly to waive the Ryan Haight Act’s in-person exam requirement for the prescribing of controlled substances, thereby ensuring millions of both established and new patients were able to receive medically necessary prescriptions via telemedicine.

There have been efforts to amend the Ryan Haight Act and encourage the DEA to activate the telemedicine special registration rule before the PHE expires, including pending federal legislation. However, to date, the Ryan Haight Act has not been changed and the DEA has not activated the telemedicine special registration rule.

Thus, when the PHE expires on May 11, without further action on the part of the DEA, the in-person requirement is set to revert, without any special registration rule or other process established to ensure continuity of care. Therefore, continued prescribing of controlled substances for patients never seen in-person, and only through virtual means during the PHE, will be prohibited and these patients would either need to be seen in-person or have their care transitioned to a local provider.


At least when I was using a TRT clinic, they required me to go to an in person visit with my PCP to get a physical and discuss going on TRT with the TRT clinic (not the through the Dr.).