23, one month Androgel, bloodwork all over the place!

Hey guys,

I have an endo appointment July 15 but am really looking for some guidance here! Often you guys have better advice than the docs. I have made about four threads and have always seen an epic response, so thank you for your efforts guys!


I am a 23 year old, semi-professional athlete, never used steroids, eat incredibly clean diet, take tons of vitamins, and unfortunately had T levels of a 70 year old, and various high cortisol tests suggesting a possible pituitary adenoma! I am in the process of getting to the bottom of that!


One month of 4 pumps Androgel, I rang in at this. For this test, I applied the gel at 2pm and was tested roughly 3 hours after.


Testosterone: 52 nmol/L (reference 8.0-29.0)
Estradiol: 96 pmol/L (reference 0-160)
FSH: 3 IU/L (reference 1-18)
LH: >1 IU/L (less than 1) (reference 1-9)
Progesterone: 4.0 nmol/L (reference 0.0-3.0)
Prolactin: 8 ug/L (reference 0-15)
DHEA: 12.3 umol/L (reference 2.2-13.0)


This was completely ridiculous and didn't make sense because I certainly didn't feel any different/better. Dialed my Androgel back form 4 pumps to 3.25 pumps. Was tested again 11 days later, this time at 10am instead BEFORE applying Androgel.


My results were as such…


Testosterone: 9.4 nmol/L (ref 8.0-29.0)
Free Testosterone: 211 pmol/L (ref 175-700)
Progesterone: 3.3 nmol/l (ref 0-3.0)
Estradiol: 55 pmol/L (ref 0-160)
FSH: 12 IU/L (ref 1-18) <— interesting how it went from 3 back to 12
LH: 4 IU/L (ref 1-9)
DHEA: 8.5 umol/L (ref 2.2-13.0) <— lowest it's been, it's always consistently at a 12.5
TSH: 0.79
SHBG: 30 nmol/L (ref 10-55)
Iron: 22 umol/L (ref 12-31)
Ferritin: 31 ug/L (ref 30-400 ug/L)

Does anyone have any insight? The first test suggested I was using WAY too much testosterone, this morning test is suggesting I need way more. That number is the worst I've ever seen it! I have also been experiencing severe depression/anxiety, not sure if it's related. What do I do?!


Thanks again everyone!

The above does not make much sense. Your T should have gone down by probably 20 to 30 percent. I would retest total testosterone.

Having said that, your increased LH and FSH tells me that your T dose is too low, which supports the T of 9.4 nmol/L but not your dose of 3.25 pumps.

Did you change application sites or T gel product? Did you get a refill in the past month? Did you get the refill of same brand and maker? Were you using moisturizer in the first month?

You're a Canadian, aren't you? I am as well, and understand that it's difficult to access the Sensitive Estradiol test - I drive to the States and arrange self-testing. I raise that point first because, even though you're using a totally inadequate test to measure your E2 level, if the level is actually high, then that would go along way to explaining why you're not experiencing the benefit of higher testosterone levels. You're likely to be told by far more experienced voices than me that you need more than TSH to evaluate your thyroid function.

What I see is a couple of things, at 23 years old you've got a serious issue if you're Low T already and I'd be traveling that road before getting on T.
Be that as it may, you're haphazard use of the gel...2pm one day testing 3hrs later, 11 days later you're using it 1000 before gel...you simply can't use this stuff in that manner and nothing with T happens between 11 days that you can test and make changes for.
Besides your age and some kind of serious problem that you're T is low, steady consistent use of the gel, everyday, same time of the day, test at no sooner that 4 weeks, 6 weeks is better. You're simply not doing yourself any good in how you're using this stuff.

Nelson Vergel said:

The above does not make much sense. Your T should have gone down by probably 20 to 30 percent. I would retest total testosterone.

Having said that, your increased LH and FSH tells me that your T dose is too low, which supports the T of 9.4 nmol/L but not your dose of 3.25 pumps.

Did you change application sites or T gel product? Did you get a refill in the past month? Did you get the refill of same brand and maker? Were you using moisturizer in the first month?

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I don't get it either Nelson. A slight discrepancy would make sense because the first test was done 3 hours after applying gel in the evening, the second test was done in the AM, but variations this high are ridiculous. I have used the same standard Androgel brand, no refills, I got two bottles on the go. Same application spots (shoulders and abdomen). I've never used moisturizer, just applied after the shower.

CoastWatcher said:

You're a Canadian, aren't you? I am as well, and understand that it's difficult to access the Sensitive Estradiol test - I drive to the States and arrange self-testing. I raise that point first because, even though you're using a totally inadequate test to measure your E2 level, if the level is actually high, then that would go along way to explaining why you're not experiencing the benefit of higher testosterone levels. You're likely to be told by far more experienced voices than me that you need more than TSH to evaluate your thyroid function.

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Yes sir, I am Canadian! You would know better than I would but I don't think the E2 is a huge huge factor (for me). I have very low body fat and none of the physical symptoms of excess estrogen. I think the issue for me lies in stress/anxiety (cortisol) overtaking my T production. Possible pituitary adenoma, I am in the process of dealing with that!

My TSH was 1.52 March 10
2.29 May 3
1.21 May 11
and 0.79 June 29.

I think it just varies.

Vince Carter said:

What I see is a couple of things, at 23 years old you've got a serious issue if you're Low T already and I'd be traveling that road before getting on T.
Be that as it may, you're haphazard use of the gel...2pm one day testing 3hrs later, 11 days later you're using it 1000 before gel...you simply can't use this stuff in that manner and nothing with T happens between 11 days that you can test and make changes for.
Besides your age and some kind of serious problem that you're T is low, steady consistent use of the gel, everyday, same time of the day, test at no sooner that 4 weeks, 6 weeks is better. You're simply not doing yourself any good in how you're using this stuff.

Click to expand...

Yes, I have been trying to get to the bottom of Low T for months now! Obviously there is an underlying issue. My ferritin/iron always checks in ridiculously low, my cortisol consistently checks in super high, energy crashes out of nowhere, my mood is all over the place...

I've been through more doctors than you would believe! At least 60% say my levels are "normal". The most credible doctor believed anxiety was causing my testosterone to drop and wanted to put me on an SSRI (which I did not want). Another wanted to put me on Clomid. I refused both because I didn't want the sexual side effects.

I have been rather irresponsible at using the gel at different times of the day, I did not know that made a difference. Will make a habit of doing it first thing in the morning.

I'm just excited to get in to see the endocrinologist July 14 and see what he has to say.

Well boys, I know it's hard to gather data with only 11 days in between tests and both tests being done at different times, but does anyone have any advice (other than being stricter on my dosage regime)? If they were in my shoes?

I already work out religiously, take vitamin D, fish oil, zinc, magnesium, methylfolate, methylcobalamin, get good sleeps, take daily cold showers, etc. Yet I see no improvement! My numbers are currently worse than they've ever been on Androgel! The doctor's don't have any advice for me (other than stopping the Androgel and trying naturally again). I know that would be a dark, long path, if there wasn't a really decent PCT involved.

I just don't know what to do anymore my friends! Thanks again!

What were your primary symptoms? It has suggested that applying transdermals with your hands, there is a transfer loss in your palms.

Your ferritin pretty low, which sometimes is associated with high volume training.

DHM said:

What were your primary symptoms? It has suggested that applying transdermals with your hands, there is a transfer loss in your palms.

Your ferritin pretty low, which sometimes is associated with high volume training.

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My primary symptoms were anxiety, depression, low libido, no morning wood, weak erections, reduced performance in training, mood swings, fatigue. The low ferritin/iron would not be caused by over training because I am responsible with diet and rest days.

Would going back up to 4 pumps (or even more) till I see the endocrinologist be a good idea or bad to be bouncing around all over the place?

Thanks!

MunchEase said:

Would going back up to 4 pumps (or even more) till I see the endocrinologist be a good idea or bad to be bouncing around all over the place?

Thanks!

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Why do you think it best to change protocols every week or two? If you have no set, stable protocol that can be measured and then assessed you'll never be able to judge how you really feel. It can, and usually does, take weeks or months to arrive at a state where you are feeling balanced. Stay where you are with your treatment, re-test your total testosterone as Nelson suggested, discuss the results with your doctor, and then make any necessary adjustments.

You're working against your own best interests by responding to all of this as you have.

MuchEase

This study found large variations in T blood levels even when measuring them at the same frequency and time. So, it is not uncommon.

Large Testosterone Blood Level Variations Found with the Use of Androgel

Nelson Vergel said:

MuchEase

This study found large variations in T blood levels even when measuring them at the same frequency and time. So, it is not uncommon.

Large Testosterone Blood Level Variations Found with the Use of Androgel

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Ah, so it is hard to measure and accurately pinpoint where you're at. In that case, would I be hypothetically be better off at a higher dose? Because a resting T Level of 9.4 nmol/L is obviously not good at any time!

MunchEase said:

Ah, so it is hard to measure and accurately pinpoint where you're at. In that case, would I be hypothetically be better off at a higher dose? Because a resting T Level of 9.4 nmol/L is obviously not good at any time!

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That's possible, but you have an appointment with your doctor in less than two weeks. You need to present stable labs going into that session. You're putting yourself at a disadvantage changing your protocol every time you hear/read/discover something new or different.

I agree that it is not be good to change my protocol rapidly, I had no idea how calculated this process is (i.e. men using rubber gloves to get the exact amount of gel, moisturizing for absorption, etc).

So, respectfully of course my friends, where do I go from here? I have learned repeatedly what I have done wrong/am not supposed to be doing (bouncing around dosages, taking Androgel at different times of day, etc), but I would love some advice on what I SHOULD do! I am still extremely lost and don't have much guidance no matter how much internet research I do (hopefully the endocrinologist will be educated on the subject and clear things up!)

Obviously nobody is going to tell me "you need to be at x dose", or "start taking x substance", but what is the next step I should take? Should I get new labs again a week from the last ones (before the endocrinologist) to get fresh numbers, and if so, at what time?

With no honest intent of being a smartass, I've used androgel 1.62 and it's too easy to read and follow their instructions which is the best you can hope for in how to use it.

MunchEase said:

I agree that it is not be good to change my protocol rapidly, I had no idea how calculated this process is (i.e. men using rubber gloves to get the exact amount of gel, moisturizing for absorption, etc).

So, respectfully of course my friends, where do I go from here? I have learned repeatedly what I have done wrong/am not supposed to be doing (bouncing around dosages, taking Androgel at different times of day, etc), but I would love some advice on what I SHOULD do! I am still extremely lost and don't have much guidance no matter how much internet research I do (hopefully the endocrinologist will be educated on the subject and clear things up!)

Obviously nobody is going to tell me "you need to be at x dose", or "start taking x substance", but what is the next step I should take? Should I get new labs again a week from the last ones (before the endocrinologist) to get fresh numbers, and if so, at what time?

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Maintain the protocol you're currently on. Have labs drawn as late in that process as you can so that your doctor will have them at the appointment you have scheduled. Go to the appointment after preparing a list of the questions you have, including those that come from your research and suggestions you find valuable here on the Forum. If your doctor is on top of this game, and not all are, not by any means, you'll spend time exploring why you appear to be hypogonadal. The issue of a particular protocol is something that should only be addressed after you understand how you, at such a young age, reached this point. You've jumped into treatment first, clinical understanding later. It's a long process. Never less than weeks, frequently months, and - often - a year or so before a guy starts to feel well. You'll get there...but not at the pace you're running.