Androgel not absorbing - Crashed T levels - seeing Endo end of month - need advice

[seegs71]

Hey Guys

New to the forum and have been reading for a few hours and figured I would introduce myself and post all in one

47yr old male with classic low T symptoms - still able to workout 4-5days/week w/weights and cardio - issues with body recomp, does not change no matter how heavy I lift or hard I diet (5'9" 195lbs @ 16%BF) - never used AAS, been on Androgel 5g package everyday applied in the AM for just over a year prescribed by Urologist - first 6-8mths felt pretty good (which is relative when you feel like crap for so long) then T levels dropped way off the last few months

Testing done every 6mths by Urologist was for Total T only while on replacement

Sept 2017 was 16.5nmol/l Range of Total T test 8.4-28.8nmol/l
March 2018 was 16.1nmol/l Range of Total T test 8.4-28.8nmol/l
Sept 2018 to 7.1nmol/l Range of Total T test 8.4-28.8nmol/l

Retest to double check Sept's low result - FMD did full panel - bloodwork all normal w/exception of slightly raised Hb/Hct/MCV which I would expect being on replacement for a year

Oct 2018

Total T 1.6nmol/l - Range 8.4-28.8
Free T 21/L - Range 196-636pmol/l
TSH 4.10 - Range .034-5.60 mIU/L
Free T4 10 - Range 8-21pmol/L
Free T3 4.9 - Range 3.7-6.5pmol/L
FSH 3.1 - Range 1.3-19.3
LH 1.8 -Range 1.2-8.6

Feel like total crap most of the time, I feel my body stopped absorbing the gel, tried rotation of sites with no improvements, Urologist wanted to increase to 7.5g Androgel but I said if I am not responding why would you increase it, his response was to not change anything and retest in 8mths which I could not even wrap my head around - so went to FMD who did the full blood panel and referred me to Endo

With such low T levels FMD referred me to an Endo and I am looking for some help in preparing for endo appointment for end of Nov (as this will be the first one) what should I expect - what questions to ask - what to research. I am thinking he will changed me over to injections but am unsure what else to ask about (HCG??)

FMD and Urologist have been no real help to date, I have been trying to research online but not much out there on Androgel that I could find, am hoping the Endo will get me some answers as he does TRT.

Thanks in advance J

 

[Vince Carter]

Were you applying the gel two hours before your blood draw?

 

[blackebob]

is this a patch or a sachet? You should try the topical gel which is a gel that comes in a pump can.

 

[Mountain Man]

Ditch the gel and get injection. Self injecting is no big deal and you know that it is getting in your system at a consistent rate. You can tell what’s going on if the amount you are taking in is not consistent.

 

[mooseman109]

I statred with gels, axrion. It worked well but was expenseive. I tried compounded creams as they were way cheaper. Very poor results, so i went injections. Happy i did

 

[seegs71]

thanks for the replies so far - all draws were done @ 9am with no gel applied before draw - I am using the sachets - 1 per day - I have coverage but its becoming a pain in the a$$ to do everyday - Urologist suggested using a nasel spray (I had never heard of it) but said it had to be done 3X per day - I said no way, it was bad enough having to do it 1X per day

I hope to move to injections - FMD advised she could do them but she did not have much experience and her recommendation would be injection 1X per month Depot test Cyp - everything I am reading about Test Cyp is half-life is 7days so preference is at least weekly injections and even better levels if the injection can be split into 2 weekly injections

In Canada prob is limited in my area to docs that do TRT and no male clinics - Endo I am seeing does TRT and also HRT for Trans so I am hoping he has a good handle on what I will need

 

[blackebob]

you need to wear out the search engine here, be your own advocate.

 

[captain]

I have always been told to apply gel before labs. I found generic fortesta to work better than Androgel. My levels on labs seems to peak later than 2hrs. Levels tend to be higher at 3-4hrs and seem stay there on labs I had done late in the afternoon. I can easily go over range with Fortesta but had a hard time getting to range with Androgel.

 

[madman]

thanks for the replies so far - all draws were done @ 9am with no gel applied before draw - I am using the sachets - 1 per day - I have coverage but its becoming a pain in the a$$ to do everyday - Urologist suggested using a nasel spray (I had never heard of it) but said it had to be done 3X per day - I said no way, it was bad enough having to do it 1X per day

I hope to move to injections - FMD advised she could do them but she did not have much experience and her recommendation would be injection 1X per month Depot test Cyp - everything I am reading about Test Cyp is half-life is 7days so preference is at least weekly injections and even better levels if the injection can be split into 2 weekly injections

In Canada prob is limited in my area to docs that do TRT and no male clinics - Endo I am seeing does TRT and also HRT for Trans so I am hoping he has a good handle on what I will need

What province are you from?

If anything definitely switch to injectable but as you should know most endos/uros are using pre-historic injection protocols as in once E2W (every two weeks) or god forbid once MONTHLY.....the high dose injections infrequently will cause horrendous peaks/troughs let alone crashing ones T levels by the time your next injection comes around.

Did you have your SHBG tested as it will dictate ones dose/injection frequency and is critical to the effectiveness of ones trt protocol?

If anything most doctors in the know at least prescribe 2x weekly injections (every 3.5 days).

When you do start injections forget the Depo-Testosterone (cypionate) as it is only precribed in a 10 ml vial @ 100 mg/ml strength (big pharma) in Canada.

The more sensible option would be Delatestryl (enanthate) as it comes in a 5 ml vial @ 200 mg/ml strength (the less volume of oil one has to inject the better especially when injecting sub-q method or injecting more frequently using lower doses).

I would definitely look into finding a new doctor to treat you.

If you run into a dead end than as long as the quack treating you will allow you to inject at home than you can use a more sensible injection protocol (depending on your SHBG).