I have been on TRT for a little over three years (Androgel 1.62 x 3 squirts/day). For a while it seemed effective. The worst symptoms ("brain fog" and perceptual distortion) went away completely within a couple of weeks, sex function and sleep patterns improved a lot, and I even restored some lean mass lost over the years. Gradually, however, it seemed like the Androgel was not working as well. For the last couple of years, my annual lab tests have indicated that my total T and free T levels have fallen back below lab reference ranges even with the Androgel. I have an annual appointment with my endocrinologist in about a week. I will ask if he will increase my dosing from 3 to 4 squirts a day to see if that helps, but I am not optimistic he will agree, since my lab results are fairly comparable to last year, when he declined to adjust my dose. (Total T now 292 ng/dL vs 301 last year; Free T at 4.8 pg/mL v 4.3 last year. All other CBC/PSA results within reference ranges both years. My E values have never measured so I have no info on that.
At this point, I am still doing better than before I started TRT, when my total T was 225 ng/dL and my free T was 23.7 pg/mL. However, I am really not satisfied with the way things are, and I will consider seeing another doctor if my current guy proposes to maintain the status quo again. (I think this is probable, as he seems highly focused on TRT risks and almost seems to regard my normal CBC results as grounds NOT to allow adjustment of my T dosing.)
However, if I do seek another doctor, I am hoping to avoid another lengthy process - only to wind up with someone who is too conservative to address my concerns. Before I started TRT, I went through numerous doctor visits and several rounds of testing over 4 months before my current doc hesitantly agreed to put me on TRT. (He said he ordinarily would not opt for TRT at a level of 225 ng/dL, but I was getting desperate because I felt like my symptoms were compromising both work and driving performance.)
If advisable, I would be willing to shift to injectible T, since I am not needle-phobic. However, I don't think it is practical for me to fit weekly or twice weekly doctor visits into my schedule, so if that were the preferred route, I would like to find a practice that teaches me how to self-inject. Also, insurance coverage will matter for me, and I suspect that may rule out some or all of the clinics with a life extension focus. Finally, if I do find someone willing to boost my T levels, I think I would feel more comfortable with a doctor who was interested in monitoring my E levels, just to make sure I don't run into trouble. (My current doc saw no reason to monitor E when I brought it up. While it is true I have had no trouble so far, I think I would feel better at least keeping an eye on it -- particularly if the doc takes me north of 450-500 ng/dL.
Does anyone think I'm barking up the wrong tree seeking to increase my T dose? I should disclose that am 62, in generally good health, and have a fairly unremarkable medical history except that (1) I was an organ donor and now have 1 kidney, and (2) I once had a blood clot (associated with a bad foot fracture), though the clot has long since been resolved. Both the organ donation and the clot preceded TRT in my case. A nephrologist looked at my kidney function a little over a year ago and concluded that my kidney function was excellent--better than many folks with both kidneys.
If I decide to do look for another doctor, I do not feel confident in my ability to find someone more suitable -- at least without a lot of trial and error that I may not have time for. If it comes to that, I will check the referrals section of the site once I have enough posts. In the meantime, I am open to any ideas members care to offer.
Thanks for any thoughts.
At this point, I am still doing better than before I started TRT, when my total T was 225 ng/dL and my free T was 23.7 pg/mL. However, I am really not satisfied with the way things are, and I will consider seeing another doctor if my current guy proposes to maintain the status quo again. (I think this is probable, as he seems highly focused on TRT risks and almost seems to regard my normal CBC results as grounds NOT to allow adjustment of my T dosing.)
However, if I do seek another doctor, I am hoping to avoid another lengthy process - only to wind up with someone who is too conservative to address my concerns. Before I started TRT, I went through numerous doctor visits and several rounds of testing over 4 months before my current doc hesitantly agreed to put me on TRT. (He said he ordinarily would not opt for TRT at a level of 225 ng/dL, but I was getting desperate because I felt like my symptoms were compromising both work and driving performance.)
If advisable, I would be willing to shift to injectible T, since I am not needle-phobic. However, I don't think it is practical for me to fit weekly or twice weekly doctor visits into my schedule, so if that were the preferred route, I would like to find a practice that teaches me how to self-inject. Also, insurance coverage will matter for me, and I suspect that may rule out some or all of the clinics with a life extension focus. Finally, if I do find someone willing to boost my T levels, I think I would feel more comfortable with a doctor who was interested in monitoring my E levels, just to make sure I don't run into trouble. (My current doc saw no reason to monitor E when I brought it up. While it is true I have had no trouble so far, I think I would feel better at least keeping an eye on it -- particularly if the doc takes me north of 450-500 ng/dL.
Does anyone think I'm barking up the wrong tree seeking to increase my T dose? I should disclose that am 62, in generally good health, and have a fairly unremarkable medical history except that (1) I was an organ donor and now have 1 kidney, and (2) I once had a blood clot (associated with a bad foot fracture), though the clot has long since been resolved. Both the organ donation and the clot preceded TRT in my case. A nephrologist looked at my kidney function a little over a year ago and concluded that my kidney function was excellent--better than many folks with both kidneys.
If I decide to do look for another doctor, I do not feel confident in my ability to find someone more suitable -- at least without a lot of trial and error that I may not have time for. If it comes to that, I will check the referrals section of the site once I have enough posts. In the meantime, I am open to any ideas members care to offer.
Thanks for any thoughts.
