Got Test results after 3 months 1% T-Gel . . . very rattled!

[Daveleeander]

I'm 68 and was diagnosed in December with lower T at 314, hematocrit at 47. I decided together with the Endocrinologist to go with his suggestion of 5gms 1% T Gel, the regular starting dose.

Fast forward to my first blood test taken yesterday after applying the gel regularly for 3 months. And my results are . . . 167 with a hematocrit of 50! That sounds pretty CRAPPY, and pretty shocking . . .

How do I feel? None of my low T symptoms have improved; the only things I feel at all are slightly sensitive nipples, a scrotum that seems tighter, and despite increased exercise and a modified diet, I haven't been able to lose any weight (in fact it's increased a few pounds).

How can this be? Maybe it's a lab test error? Maybe I don't absorb it well? But then how could my hematocrit go up? Help, really need some suggestions here . . .

Gel doesn’t have a very good record for absorption. Cream does much better, and there is very little roller coaster. I’m 69 and have been injecting for 11 years now. I’m in a couple groups and your problem is a common one from those who have been given gel by doctors who don’t know a whole lot about trt.

 

[madman]

Can you explain the reason for the difference to the study data you referenced?

*Variable rate of absorption.

*Skin structural differences may be one of the causes of these significant variations in bioavailability of drug

*As significant day-to-day variability of serum T levels due to absorption or other reasons is likely, especially in older men




*Recent studies in older hypogonadal men have shown that after testosterone gel application there were large fluctuations in serum testosterone concentration both within and between patients [8]. Skin structural differences may be one of the causes of these significant variations in the bioavailability of the drug, which poses challenges in predicting the effectiveness of medication and determining an adequate dose, as well as an appropriate time for testing serum testosterone levels [8, 32]. Non time-dependent pulses of serum testosterone also occur in relation to exercise and skin temperature. Both factors may be mediated through changes in dermal blood flow.


*Different sites for drug application have been studied with various degrees of success. Scrotal skin is thin and highly vascular hence it leads to better and sustained absorption of testosterone, which made it one of the early targets in the development of transdermal patch preparations. Scrotal application is not used for the gels because of the relatively small area where the gel can be applied. Application on the axillary region may enhance absorption and may cause less skin transfer, and has been shown to be beneficial to patients who failed other transdermal preparations in a single study [34]. However, because the skin is sensitive in the area, skin irritation, edema, and erythema have been observed as in other transdermal preparations [35]. On the other hand, even though the application of 1.62 % testosterone gel on abdominal skin led to 30–40 % lower availability than on the upper arms and shoulders, application on all of these sites resulted in eugonadal testosterone levels [36]. While a selection of an application site may not be an issue for most patients, those failing to achieve sufficient systemic levels may benefit from a change of site.


*Additionally, some gels include emollients that prevent skin drying and ensure better testosterone absorption. There are data to suggest that this may help achieve better bioavailability and higher serum concentrations [37]


*For monitoring of testosterone concentrations after transdermal gel application, blood for dose adjustment should be drawn 2–8 h after the application following manufacturers recommendations. As significant day-to-day variability of serum T levels due to absorption or other reasons is likely, especially in older men [9], major dosing decisions should not be made based on a single measurement.

 

[Ancart]

I'm 68 and was diagnosed in December with lower T at 314, hematocrit at 47. I decided together with the Endocrinologist to go with his suggestion of 5gms 1% T Gel, the regular starting dose.

Fast forward to my first blood test taken yesterday after applying the gel regularly for 3 months. And my results are . . . 167 with a hematocrit of 50! That sounds pretty CRAPPY, and pretty shocking . . .

How do I feel? None of my low T symptoms have improved; the only things I feel at all are slightly sensitive nipples, a scrotum that seems tighter, and despite increased exercise and a modified diet, I haven't been able to lose any weight (in fact it's increased a few pounds).

How can this be? Maybe it's a lab test error? Maybe I don't absorb it well? But then how could my hematocrit go up? Help, really need some suggestions here . . .

Gel sucks imo. Find a clinic… docs are dumb

 

[Cooper]

Gel doesn’t have a very good record for absorption. Cream does much better, and there is very little roller coaster.

Have you tried cream?

 

[Melody68]

I'm trying to get off this gel, and onto injectibles, but having challenges with the prescribing doctor.

 

[Melody68]

Finally got the endo to prescribe Test e for me. Tomorrow is my first shot; I've assembled most everything. Though I think I'll eventually go into delts, right now I'll inject into the thigh with a 25g x 1" needle. I've had so many problems with absorbing the gel that I just want to make sure I've got something reliable for a while. There will probably be other concerns I have to deal with . . .