1. #1

    TRT started great, but...

    My total testosterone started at 165 ng/dL, SHBG at 7 nmol/L, and 48.3 pg/mL free testosterone. Usual symptoms: low libido and high fatigue. The doctor prescribed Androgel 1%, 50mg/day.

    I started and three weeks later I was great. I went back to the gym, libido was back, etc. At about week 5, I crashed really hard, to the point that I would do literally nothing until 11 AM and would need a nap at 3 PM.

    I'm starting with Defy medical, but this is going to take 4 weeks between tests, exams and consultations. Meanwhile, any suggestions of what I should do, or look into?

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  3. #2
    Your numbers seem really odd, any typos? EDIT: OK, I think I see what's up... are these Quest numbers? Posting the reference ranges would be really helpful.

    Also, seems like really incomplete info. If you don't have it yet, get your Defy blood work done pronto and post results here.

    That said, crash at 5 weeks is pretty common as your LH and your own testicular production of T shuts down. You really need labs done to find out what is happening.

    BTW, feel for you, I am waiting for Defy as well, and for my own odd reasons the wait has been several months. It has gotten desperate. Good luck and hang in there!
    Last edited by Blackhawk; 08-12-2017 at 12:37 PM.

  4. #3
    You are likely to have exhausted your TRT honeymoon phase. It can happen, particularly quickly with topical preparations. You endogenous testosterone, low as it was, and your exogenous testosterone gel combine at the start of therapy to lift your levels and send you into a dopamine filled bliss. Then your axis shuts down, as it does with everyone on a TRT protocol, and you feel...flat. Now the hard work begins as the effort to balance things gets under way.

    In my own case, topicals failed - as they do a good number of guys - and I never felt anything like those early days again with gels. A switch to injections was the key to TRT success. All options will be explored with Defy.
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

  5. #4
    I had a big boost on topical at the beginning but then felt lower then before. I always have that dopamine boost when my dht is high so I guess that was the reason behind it.. thats why I prefer low dose injections to not bring dht too high so it feels more stable then big boost and then feeling like low T again

  6. #5
    Quote Originally Posted by FabianMontescu View Post
    My total testosterone started at 165 ng/dL, SHBG at 7 nmol/L, and 48.3 pg/mL free testosterone. Usual symptoms: low libido and high fatigue. The doctor prescribed Androgel 1%, 50mg/day.

    I started and three weeks later I was great. I went back to the gym, libido was back, etc. At about week 5, I crashed really hard, to the point that I would do literally nothing until 11 AM and would need a nap at 3 PM.

    I'm starting with Defy medical, but this is going to take 4 weeks between tests, exams and consultations. Meanwhile, any suggestions of what I should do, or look into?
    Post your labs with ranges so everyone understands what you tested pre-trt for blood work. If you had labs done at Quest the reference range for shbg for ages 18-55 is (10-50nmol/L) yours is very low 7 nmol/L you may be in for a difficult road ahead as low shbg can cause issues.

  7. #6
    i had similar stuff with topical testosterone but higher concentration then androgel. big boost in the beginning and then crashed hard like you stated.. switched back to injections and am waiting for thing to stabilize.. didn't like the topical at all not for me

  8. #7
    Thank you so much for the answers. Sorry for not posting the ranges - they are the Quest ranges. So my labs before starting Androgel were:

    Total Testosterone: 165 out of 250-1100 (ng/dL)
    SHBG: 7 out of 10-50 (nmol/L)

    The others seemed fine:
    Free Testosterone: 48.3 out of 35.0-155.0 (pg/mL)
    FSH: 3.5 out of 1.6-8.0 (mIU/mL)
    LH: 2.6 out of 1.5-9.3 (mIU/mL)
    Prolactin: 10.3 out of 2.0-18.0 (ng/mL)

    Will start looking at the problems with the SHBG being so low. Again, thanks for the help.

  9. #8
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    Quote Originally Posted by FabianMontescu View Post
    Thank you so much for the answers. Sorry for not posting the ranges - they are the Quest ranges. So my labs before starting Androgel were:

    Total Testosterone: 165 out of 250-1100 (ng/dL)
    SHBG: 7 out of 10-50 (nmol/L)

    The others seemed fine:
    Free Testosterone: 48.3 out of 35.0-155.0 (pg/mL)
    FSH: 3.5 out of 1.6-8.0 (mIU/mL)
    LH: 2.6 out of 1.5-9.3 (mIU/mL)
    Prolactin: 10.3 out of 2.0-18.0 (ng/mL)

    Will start looking at the problems with the SHBG being so low. Again, thanks for the help.
    Since starting TRT you haven't done labs, it's tough being a low shbg guy, like many on the form. I hope you're comfortable with injecting T, I use Easy Touch syringes. They are very easy to use.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  10. #9
    Low SHBG is not bad, stop perpetuating that myth already.

  11. #10
    Quote Originally Posted by Vince Carter View Post
    Low SHBG is not bad, stop perpetuating that myth already.
    Just to be clear I stated low shbg can be difficult and never stated it is bad as they have two completely different meanings. I meant no disrespect to anyone with low shbg hence why I have never said it is bad. My apologies if anyone misunderstood.

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