Possible false HIGH total testosterone blood test level?

[ChristmasElf]

First total serum testosterone blood level after three weeks on Fortesta 2% (generic) with four pumps (40 mg total) 5 hours after application of T gel was 1398 NG/DL flagged HIGH with ref 348-1197 from Labcorp. Free T and estradiol results to follow. I was applying the T gel to my shoulders and upper arms I was very careful not to come anywhere near the in normal draw site and briefed the tech not to go much above the draw site with his sterile wipe, and he did not. But since the testerone number was so high above anything normally seen with four pumps of the testosterone gel i'm thinking there's a pretty good chance that i somehow contaminated the site. I was using the tips to increase absorption by applying the gel within three minutes after showering, and applying a moisture 12 hours after applying the testosterone but can't believe those could increase the testosterone level so much. I had this blood work done myself to prepare myself for my follow up with my primary care doctor on Friday where he will ask how I am feeling take his first blood draw to determine adjustments to dosage. My T level prior to commencing TRT was 193. I do you think I'm beginning to feel some positive effects from the testosterone but nothing over-the-top. And starting two days after I see the RT I began to gain weight steadily and have gained 6 pounds in three weeks. I now weigh 134 pounds. Do people agree that 1398 is likely a false high rating?

 

[ERO]

That does seem high since so many guys never get even close with TDs and have to switch to shots It would not hurt to get a second blood test double check.

Do you use an AI? a 6lb weight gain in 3 weeks sounds like potential water weight due to high E2

 

[ChristmasElf]

Don't use an AI but a number of folks have told me that an initial water weight gain when starting is not unusual and that it happens with many "steriods." Thanks for your comments.

 

[CoastWatcher]

I would certainly want to know what the free test comes in at - and I'd probably ask for a retest. As for water retention, I had a very mild experience with it on Androgel, which never moved my numbers, but the edema cleared within a month to five weeks. Never a problem after that.


Keep us posted.

 

[Vince Carter]

It would be best if you had a blood draw and then applied the gel after, wouldn't it?

 

[Jasen Bruce]

Hello Chris
Thank you for posting your details
First, 1398ng/dl is not too high. The Labcorp references ranges are conservative. I have healthy men with no prior TRT/AAS use with total T in the high 1300s. Individual men respond differently to different levels within the upper normal range. For some, 1200ng-1300 might be too high and cause side effects, while other men feel best at this level with zero side effects. All depends on genetics and hormone metabolism. 5 hours after applying the T gel would catch you on the higher end of your peak, testing the morning of (prior to admin. your daily dose) would find the number a bit lower. Although you do not want your T levels over 1300ng, if you feel good, are experiencing no side effects, and blood markers are in order than I would not worry.

As for it being a false high, it can happen in labs. This is one reason a good doctor never goes off a single blood test but usually observes blood over a period of time, follow ups, etc. In this case it may not be a false high since 1300ng is a physiological level. Your phlebotomist appeared to follow your instruction on where to draw which mitigated contamination.

You can always draw T F&T again just to be sure it was not a lab error.

 

[Nelson Vergel]

ChristmasElf

You may be one of those men who gets great T blood levels with T gels. Not unheard of.

 

[ChristmasElf]

Thanks Jason for your good input. I agreed that it would be better to get the T levels shortly before taking the next dose. The instructions to the doctors tell them to take the draw two hours after the doses been administered. I suspect the pharmaceutical company is more interested in keeping the FDA happy you're not going over the upper physiological limits then they are finding out what the true trough is. I just didn't realize that on only 40 mg of 2% testosterone gel there was even a chance that you could get to 1398. My pc doc will take his blood draw this Friday and combined with my feeling of how I'm doing will adjust if needed. I have some more energy, making a few more games in the gym, but still lose some energy starting late afternoon, and very little improvement in Sexual performance. But definitely going in the right direction. I do really want to be at the upper end of normal if I'm going to go through all of this. I may be calling Defy to discuss your HCG support program when I get my test stabilized. Not quite convinced yet it's necessary at this time but sure like all the support that program provides. Especially the knowledge on TRT that is not there with my primary care doc.

 

[ChristmasElf]

Nelson, thanks for reading my post and I sure hope I am one of those guys that get good results out of T gel. Although I have some vision left my field of view is very limited in that vision is likely to go away in the next few years. The S a T gel would be much easier for me than trying to inject every week. If I end up using hCG that injection I think would be much easier for me to administer. But first I want to get my testosterone levels stabilized in up there at the high-end of normal.

 

[Nelson Vergel]

Just make sure to keep an eye on these parameters:

Blood Tests Needed Before and During Testosterone Replacement Therapy

 

[ChristmasElf]

Four-month TRT update on my T levels with Fortesta 2% T gel.
5 June labs:
Total T 1287 (346-1197)
Free T (direct) 27.86 (6-18.1pgml)
Estradiol sensitive 68.1 (8-35 of/ml
SHBG 39.5%
DHT 231 (nigh no red range)

Blood draw approximately five hours after T application still in the initial spike. Was using for pumps each morning after a very warm shower. Also applied moisturizer in the evening. I felt very good on four pumps of T gel.

Went to a new doctor 23 June. He was much more knowledgeable in TRT and even recommend I read Nelson's book, which of course I had. He wanted to lower my T level to try and get both DHT and E2 down a little. His hope was to find the sweet spot where I would get the good testosterone effects while lowering E2 and DHT. He said to try three pumps a day vice 4 for a month and come back to see him.

22 July labs
Total T 1190
Free T direct 31.1
Blood draw approximately five hours after T application which is still in the initial spike.

23 July labs
Total T630
Free T Direct 13.3
Blood draw approximately 10 hours after application of T. Just about out of the initial Spike and at a level that should maintain for the rest of the 24 hours. I have still felt pretty good with three pumps but games in the gym have been significantly harder, in recovery times noticeably longer.

I believe the high E2 and DHT levels are due to the very high spike at the beginning of the 24 hours. I was thinking that if I went back to four pumps of TGL but divide that in half two pumps in the morning and two pumps in the evening would significantly lower the spike in there for E2 and DHT while allowing my long-term total T levels to be up some. Thoughts from the group or other ideas.

 

[CoastWatcher]

Did you measure estradiol after you adjusted your protocol? Did you have any subjective sense that it was a problem? Was a CBC run, by chance?

 

[ChristmasElf]

Dr. did not test for E2 this time as he knows that if he brings the test level down the DHT and E2 should come down as well. I will get my own E2 test. I do not have any subjective indications of E2 problems. Yes CBC Hemicrit has risen from 46.1 in February to 48 and will closely watch

 

[ChristmasElf]

Coast watcher, or anyone else, have thoughts on weather going up from 3 to 4 pumps splitting up my daily dose into two pumps in the morning into pump in the evening will significantly reduce the initial rapid rise of total t..

 

[HarryCat]

I'm in a similar situation, except using 20% compounded cream. Last time I was tested, 3 hours after application, total T was over the top of the reference range. I too thought it was a false high. My doc didn't think so.

I asked him about splitting up the dose, I was thinking maybe even going to 3 times a day, and he said he would rather have me try a lower dose but stick with the once per day application. So that is what I've been doing for the past week.

 

[Nelson Vergel]

Harry

Where do you get your cream?

 

[CoastWatcher]

Coast watcher, or anyone else, have thoughts on weather going up from 3 to 4 pumps splitting up my daily dose into two pumps in the morning into pump in the evening will significantly reduce the initial rapid rise of total t..

One possible issue that occurs right away relates to how your system responds to the topical. Do you feel a surge of energy, are you likely to have sleeping issues if you apply at night?

 

[HarryCat]

Harry

Where do you get your cream?

I used to get it from Women's International Pharmacy, but now I get it from The Medicine Shoppe Pharmacy.

 

[DHM]

What are your application sites? Are you rubbing the TD onto your forearm where they are drawing from?

 

[ChristmasElf]

DHM although Fortesta recommends inner and front thigh I apply on my shoulders with doc approval.