On Androgel - Looking for Guidance

[retro]

So I asked for blood tests after being on a bodybuilding forum and reading lots about lack of energy in relation to low testosterone. I had low libido. very poor energy to the point of being fatigued ! lack of motivation. hard to get and maintain erections. feeling low and social anxiety !

here are all the bloods I have had over a year and some details to how I feel. Any advice would be great. I am here to learn

4th FEB 2016

SHBG 35nmol ( 10.0 - 80.0 )
SERUM TESTOSTERONE LEVEL 10.6 nmol ( 9.0 - 31.6 )
SERUM PROLACTIN LEVEL 187 mIU/L ( 86.0 - 324.0 )
SERUM TSH LEVEL 1.17 mIU/L ( 0.3 - 5.0 )
SERUM LH LEVEL 2.1 IU/L
SERUM OESTRADIOL LEVEL 44 pmol/l
SERUM ALPHA-FETOPROTEIN LEVEL 2.7 kIU/I ( 5.8 )
HCG 2.0 IU/L ( 5.0 )
NUCLEAR AUTOANTIBODY CREENING TEST NEGATIVE
MITOCHONDRIAL ANTIBODY SCREENING TEST NEGATIVE
ANTI-SMOOTH MUSCLE AUTOANTIBODY LEVEL MEGATIVE
PARIETAL CELL AUTOANTIBODY LEVEL NEGATIVE
ANTI-LIVER-KIDNEY MICROSOMAL ANTIBODY LEVEL NEGATIVE



24TH OCT 2016

SERUM PROLACTIN LEVEL 256 mIU/L ( 86.0 - 324.0 )
SERUM LH LEVEL 3.4 IU/L
SERUM FOLLICLE STIMULATING HORMONE LEVEL 6.5 nmol/l ( 9.0 - 31.6 )
SERUM TESTOSTERONE LEVEL 6.5 nmol ( 9.0 - 31.6 )
Low testosterone confirmed without gonadotropin response suggesting secondary hypogonadism
SHBG 28 nmol/L ( 10.0 - 80.0 )

19TH JAN 2017 TAKEN ON FIRST VISIT TO ENDO

SERUM FOLLICLE STIMULATING HORMONE LEVEL 2.2 IU/L ( I.3 - 19.3 )
SERUM LH LEVEL 2.3 IU/L ( 1.2 - 8.6 )
SHBG 26 nmol/L ( 13.0 - 90.0 )
FREE ANDROGEN INDEX 31.2 ( 15.0 - 102.0 )
SERUM TESTOSTERONE LEVEL 8.1 nmol ( 6.0 - 27.1 )


23RD OF FEB

STARTED TRT, 1 SACHET OF TESTOGEL EACH DAY APPLYING TO UPPER ARMS, SHOULDERS AND EXCESS ON TRAPS AT APPROX 11 AM. Felt sick for a few days but a sense of well being. Energy and libido both went up slightly. Towards the 1 month mark my nipples got very sore and i had discomfort in abdomen bladder area with a need to pee and burning pee. this seemed to go of its own accord and nipples got less sore !

23TH MAR 2017 11:53 1 MONTH INTO TRT 22 HOURS AFTER 50MG TESTOSTERONE FROM 5 G TESTOGEL

SERUM OESTRADIOL LEVEL 170 pmol/l (0.0 - 172.0 )
SHBG 29 nmol/L ( 13.0 - 90.0 )
FREE ANDROGEN INDEX 31.2 ( 15.0 - 102.0 )
SERUM TESTOSTERONE LEVEL 10.5 nmol ( 6.0 - 27.1 )
SERUM TOTAL PROTEIN LEVEL 75 g/L ( 60.0 - 80.0 )
SERUM ALBUMIN LEVEL 47 g/L (60.0 - 80.0 )
SERUM GLOBULIN LEVEL 28g/L ( 21.0 - 37.0 )
SERUM TOTAL BILIRUBIN LEVEL 16 umol/L ( 0.0 - 20.0 )
SERUM ALANINE AMINOTRANSFERASE LEVEL 24 U/l ( 10.0 - 40.0 )
SERUM ALKALINE PHOSPHATASE LEVEL 61 U/L ( 30.0 - 130.0 )

Still going ok , had a few up and down days. after the 1 month mark the good feelings seemed to wear off and i felt similar but slightly better then before trt

02 MAY 2017 18:00 JUST OVER 2 MONTHS INTO TRT TAKEN 31 HOURS AFTER 50MG TESTOSTERONE FROM 5G TESTOGEL

SHBG 28 nmol/L ( 13.0 - 90.0 )
FREE ANDROGEN INDEX 30.7 ( 15.0 - 102.0 )
SERUM TESTOSTERONE LEVEL 8.6 nmol ( 6.0 - 27.1 )
SERUM TOTAL PROTEIN LEVEL 71 g/L ( 60.0 - 80.0 )
SERUM ALBUMIN LEVEL 45 g/L ( 60.0 - 80.0 )
SERUM GLOBULIN LEVEL 26 g/L ( 21.0 - 37.0 )
SERUM TOTAL BILIRUBIN LEVEL 14 umol/L ( 0.0 - 20.0 )
SERUM ALANINE AMINOTRANSFERASE LEVEL 34 U/l ( 10.0 - 40.0 )
SERUM ALKALINE PHOSPHATASE LEVEL 61 U/L ( 30.0 - 130.0 )
PROSTATE-SPECIFIC ANTIGEN LEVEL 0.92 ug/L ( 0.0 - 2.0 )

The week i had these bloods done i hit PR's in the gym and at 39 i was pretty pleased with that ! was feeling good. I then read 1 day after this that i had probably been rubbing the gel in to much and possible evaporating the gel so the testosterone would not absorb as much. I began using an old testogel packet cut open to spread the gel over upper arms and shoulders with not some on side abdomen and some on balls. the gel would sit evenly but thicker on my arms and dry naturally.


An hour or so after o would apply a moisturizer. a few days after this i started feeling slight tremors ! i stopped taking my pre workout which contained caffeine as it was to intense which does not usually effect me. i also started getting headaches and short of breath with dizzy spells ! my mood also changed and felt a bit low but my energy was well up. my appetite was up and my libido was very high ! the tremors got worse and I became very anxious, This was general anxiety as i would get it sat at home by myself ! it came and went in waves, mainly in the morning and later at night !

I spoke to a doctor about this and they said in last bloods i was dehydrated and maybe just take half a sachet for a few days and see if it subsides. I explained the way i was putting it on and they said i maybe absorbing more ! i feel its to do with estrogen but i am not sure ! 4 days now on half a sachet and i am feeling slightly better. have also started DIM at just 100mg a day to see if it helps


It got me to the point that i was thinking about quitting the TRT but maybe i have to ride it out ?

 

[JMP]

Retro, welcome to Excel. The three things that I notice from reading you post and just about every post on this site over the last 4 months is that you added the gel to your scrotum which raises DHT significantly most likely causing the very high libido. But with DHT high I'm not sure how it would relate to your other symptoms. Test DHT in your next blood workup. Also, I don't see a estradiol sensitive test. Therefore you have no idea where your estradiol levels are and whether they could be a factor. Finally the gels tend to be weak as compared to injections or high percentage compounded creams leading to your test levels not really coming up much to see the true effects of TRT. Your levels should be above the 50% level in the range to see results. In other words double what they are now. I hope that helps a bit. No need to quit TRT, but you have some work to do.

 

[retro]

Retro, welcome to Excel. The three things that I notice from reading you post and just about every post on this site over the last 4 months is that you added the gel to your scrotum which raises DHT significantly most likely causing the very high libido. But with DHT high I'm not sure how it would relate to your other symptoms. Test DHT in your next blood workup. Also, I don't see a estradiol sensitive test. Therefore you have no idea where your estradiol levels are and whether they could be a factor. Finally the gels tend to be weak as compared to injections or high percentage compounded creams leading to your test levels not really coming up much to see the true effects of TRT. Your levels should be above the 50% level in the range to see results. In other words double what they are now. I hope that helps a bit. No need to quit TRT, but you have some work to do.

Thanks for taking the time to read ! I stopped rubbing gel on scrotum ! The high libido is not an issue ! In fact I like it !! It's the anxiety that's getting to me ! I have no idea how to do an estrogen sensitive test ! Nor the money to do that private I doubt ! Obviously I want my test to be higher but not at the expense of increased sides :-/

 

[JMP]

Ok slow down for a second. The estradiol sensitive test is $48 through Nelsons dicountedlabs.com click lab tests at the top of the main forum page. I didn't say to stop putting the gel on the scrotum, just to test DHT to make sure that it is not too high and causing some of the anxiety and other symptoms. From what I've read (no personal knowledge or experience) is that if you use the gel every day on the scrotum your DHT will go way too high. Once a week or even once every two weeks might keep your dht and libido raised but not skyrocket the levels. Testing however is imperative to know for sure. Having things in balance is the key to feeling good. It will take time, testing, patience, and yes a bit of money. Let me make clear that I am not a doctor and am just relaying the information that I have learned through the forum and personal research.

 

[JMP]

https://www.excelmale.com/forum/sho...r-Cream-on-Your-Testicles-for-Best-Absorption

 

[CoastWatcher]

It's clear you don't live in the US - based in units your labs are reports in and spelling! If that's the, the sensitive estradiol test is unavailable to you. Where do you live?

 

[Vince]

I would think about switching to injections, better way to control your levels.

 

[Vince Carter]

When you're on daily cream/gel you always apply it and about an hour or two later is when you pull labs, totally opposite of injections and troughs. You're doing your labs wrong and thus your numbers continue to look low; 02 MAY 2017 18:00 JUST OVER 2 MONTHS INTO TRT TAKEN 31 HOURS AFTER 50MG TESTOSTERONE FROM 5G TESTOGEL

 

[FeelingLost]

When you're on daily cream/gel you always apply it and about an hour or two later is when you pull labs, totally opposite of injections and troughs. You're doing your labs wrong and thus your numbers continue to look low; 02 MAY 2017 18:00 JUST OVER 2 MONTHS INTO TRT TAKEN 31 HOURS AFTER 50MG TESTOSTERONE FROM 5G TESTOGEL

Hi Vince what is the half life of the T they put in the Gel?
Is there really a trough with daily gel application?

If you are applying gel every day I would think your T lvl would be pretty darn steady after 6-8 weeks.
Especially if you always fast, no ejacks for 48 hours and had your blood draw early morning (8-8:30am) everytime.

 

[retro]

Ok slow down for a second. The estradiol sensitive test is $48 through Nelsons dicountedlabs.com click lab tests at the top of the main forum page. I didn't say to stop putting the gel on the scrotum, just to test DHT to make sure that it is not too high and causing some of the anxiety and other symptoms. From what I've read (no personal knowledge or experience) is that if you use the gel every day on the scrotum your DHT will go way too high. Once a week or even once every two weeks might keep your dht and libido raised but not skyrocket the levels. Testing however is imperative to know for sure. Having things in balance is the key to feeling good. It will take time, testing, patience, and yes a bit of money. Let me make clear that I am not a doctor and am just relaying the information that I have learned through the forum and personal research.

I stopped applying to scrotum a week ago as I thought it's best to stop anything I had changed. After a bit more reading high dht might over stimulate the CNS which may cause anxiety! Not sure how concrete that statement is but I will look into it more

It's clear you don't live in the US - based in units your labs are reports in and spelling! If that's the, the sensitive estradiol test is unavailable to you. Where do you live?

I am in the UK

When you're on daily cream/gel you always apply it and about an hour or two later is when you pull labs, totally opposite of injections and troughs. You're doing your labs wrong and thus your numbers continue to look low; 02 MAY 2017 18:00 JUST OVER 2 MONTHS INTO TRT TAKEN 31 HOURS AFTER 50MG TESTOSTERONE FROM 5G TESTOGEL

stupidly I was hoping if my numbers were still low I would get put on shots but I probably messed up any proper results coming through :-/

 

[retro]

Ok slow down for a second. The estradiol sensitive test is $48 through Nelsons dicountedlabs.com click lab tests at the top of the main forum page. I didn't say to stop putting the gel on the scrotum, just to test DHT to make sure that it is not too high and causing some of the anxiety and other symptoms. From what I've read (no personal knowledge or experience) is that if you use the gel every day on the scrotum your DHT will go way too high. Once a week or even once every two weeks might keep your dht and libido raised but not skyrocket the levels. Testing however is imperative to know for sure. Having things in balance is the key to feeling good. It will take time, testing, patience, and yes a bit of money. Let me make clear that I am not a doctor and am just relaying the information that I have learned through the forum and personal research.

I stopped applying to scrotum a week back as I thought I better to stop anything I started when I got the side effects ! I just read that high dht can over stimulate the cns cause anxiety?? Not sure how true that is though

It's clear you don't live in the US - based in units your labs are reports in and spelling! If that's the, the sensitive estradiol test is unavailable to you. Where do you live?

UK

I would think about switching to injections, better way to control your levels.

Unfortunately my endo wants me to continue with the gel !

 

[Vince]

Unfortunately my endo wants me to continue with the gel !

Any chance of finding a new doctor.

 

[Will Brink]

Unfortunately my endo wants me to continue with the gel !

Can you inquire as to why? Not sure about UK, but there's also a big cost difference between them in the US. I have generally been un impressed with both clinical responses and subjective responses with topicals, but he may at least allow you to increase the dose if levels remain low.

 

[madman]

Hi Vince what is the half life of the T they put in the Gel?
Is there really a trough with daily gel application?

If you are applying gel every day I would think your T lvl would be pretty darn steady after 6-8 weeks.
Especially if you always fast, no ejacks for 48 hours and had your blood draw early morning (8-8:30am) everytime.

https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.85.12.7045

 

[Vince]

When AndroGel treatment is discontinued after achieving steady state, serum testosterone levels remain in the normal range for 24 to 48 hours but return to their pretreatment levels by the fifth day after the last application.
https://thinksteroids.com/community...els-after-using-discontinuing-androgel.18331/

 

[CoastWatcher]

Should you wish to change doctors, I bring to your attention Dr. Robert Stevens. He maintains a private clinic in Dorset. A friend of Nelson's, his practice incorporates leading edge protocols.

 

[retro]

Since last posting I halfed my dose and the lightheadedness and anxiety subsided loads ! On Tuesday the endo had ask for another blood test 2 hours after application. So the Saturday before I went back on 1 full sachet a day. Had bloods done Tuesday and endo called to say he has wrote to me the results ! After I told him the side effects I was having he has suggested trying tostoran instead of testogel ! Then 4 weeks after repeat bloods ! Today and yesterday I have felt anxious again so side effect of gel ?? Who knows ! But at least he's prepared to try something else !! My arms are a bit spotty where I apply the gel but nothing too bad.

 

[retro]

Results back in ! 2 hours after 1 sachet of testogel my bloods cameback at 27 !!! This is why he wants me to change to tostran as I can have a slightly lower dose ! So..........Has the gel being on my skin which is pretty much where blood test was taken made the results higher ? Or if that's genuine then how has high test resulted in my feeling anxious and crappy ?? I don't seem to have had the "side effects" associated with high test !! Oily skin, acne, strength etc etc

If that's genuine then are my side effects because estrogen has gone up ? Although nipples are not sensitive or water retention etc etc ! Confused !!!

 

[Vince Carter]

Results back in ! 2 hours after 1 sachet of testogel my bloods cameback at 27 !!! This is why he wants me to change to tostran as I can have a slightly lower dose ! So..........Has the gel being on my skin which is pretty much where blood test was taken made the results higher ? Or if that's genuine then how has high test resulted in my feeling anxious and crappy ?? I don't seem to have had the "side effects" associated with high test !! Oily skin, acne, strength etc etc

If that's genuine then are my side effects because estrogen has gone up ? Although nipples are not sensitive or water retention etc etc ! Confused !!!

yes you should never apply the gel and then have blood drawn at the same location, compromises the test result.

 

[retro]

yes you should never apply the gel and then have blood drawn at the same location, compromises the test result.

I didn't plan that ! I applied gel to left arm and got bloods from right arm but she messed it up and took from left arm ! Do I ask to retest ?