Bloated and Swollen on Testosterone: What Tests to Run

[tomas]

Started on a daily regiment of testosterone cream the first week was good then it has been all down hill from there. It has been just over one month now and I am feeling worse everyday. After I take it I feel more swollen than before. Tomorrow I am going to get some blood drawn to see if I can figure out what the heck is going on. What would be the recommended tests to have done?

From what I have read it sounds like conversion to estradiol. So wondering if i should just order free and total testosterone and sensitive estradiol or a complete panel?

Note I tried TRT years ago and had the same symptoms and my managing doctor did not run any follow up tests or really have any suggestions at the time so I ended TRT. So this is nothing new but I am not sure what would be causing this issue and would love to run tests and figure it out once and for all so I can get dialed in properly this time. Before starting TRT I naturally run borderline low on free and low on total.

 

[CoastWatcher]

Total and free testosterone
SHBG
Estradiol/Sensitive
CBC
CMP

Discountedlabs.com has excellent prices. I am assuming you had a complete workup, with proper testing before starting treatment. Is that true? Do you have those results? You also need to find a doctor who understands how TRT is managed. You deserve better care.

 

[tomas]

Thanks. The new doctor is working with me on this a lot better than the last one I had. Initial labs were fine except for the low testosterone. It looks like I should do the full lab panel I have an order for.

Free T4 and T3
DHEA
Cortisol
TSH
Estradiol
PSA
SHBG
Testosterone Free and Total
Pregnenolone
CBC
CMP
DHT

I guess when I get this back I hopefully will have an answer.

 

[tomas]

Another thing I have noticed is my face gets warm 30 minutes after applying the cream even in small doses.

 

[Vince]

Another thing I have noticed is my face gets warm 30 minutes after applying the cream even in small doses.

Have you ever considered switching to injections. I feel most men do better with injections, then gels or creams.

 

[tomas]

Yes I would prefer to go the injectable route but my current doctor is not comfortable in having enough knowledge and would have to refer me out to a endocrinologist.

 

[CoastWatcher]

Yes I would prefer to go the injectable route but my current doctor is not comfortable in having enough knowledge and would have to refer me out to a endocrinologist.

I take it you require a referral for insurance purposes? Are you in a position that you could consult a doctor on your own, on a cash basis? Typically, that is the way the leading doctors in this field structure their practices. The cost may not be as prohibitive as you fear. We can certainly provide you with referrals. It is the course a vast number of members here follow.

 

[tomas]

I take it you require a referral for insurance purposes? Are you in a position that you could consult a doctor on your own, on a cash basis? Typically, that is the way the leading doctors in this field structure their practices. The cost may not be as prohibitive as you fear. We can certainly provide you with referrals. It is the course a vast number of members here follow.

If it is not immediately clear what the problem is from the latest lab test results then that would probably be the best approach to take. I am not dealing with insurance just a lack of medical professionals in the local area.

 

[Vince]

If it is not immediately clear what the problem is from the latest lab test results then that would probably be the best approach to take. I am not dealing with insurance just a lack of medical professionals in the local area.

I agree, get your labs and see where you stand. But it does sound like you'll probably do better with injections.

 

[CoastWatcher]

Prime Body and Defy Medical are national practices and site sponsors. I am not a patient of either, but I can attest to the care they give an enormous number of Excelmale members. They operate on different models, but are national in scope. Plug "Justin Saya" into the search box here and read the posts from Defy's medical director. Then call both Defy and Prime Body, after going to their websites, and ask the most direct, blunt questions you can think of. Cost, delivery of care, they won't dodge.

 

[THE-DET-OAK]

If your testosterone cream is less than 10-15% that is your primary problem. Creams work good for some guys, as long as its strong enough. Otherwise it just converts to estrogen rather than raising your TT levels substantially.

 

[rhino5169]

Here's a good read from the Defy website

http://defymedical.com/blog/item/28-compounded-testosterone-gels-creams-for-topical-application

 

[tomas]

Okay so I got my lab tests back. Testosterone is low and converting to DHT like crazy since I am applying 200mg of 20% Testosterone cream on scrotum based upon my original doctor and matching this protocol:
http://www.hormonesolutions.com/blo...-times-more-effective-than-to-the-upper-body/

Clearly this protocol is not working and will have to change it. I am wondering if I should just give it another shot on normal skin? I see suggestions of 1/2 to 1 gram of 20% daily to normal skin, would that be correct? Then measure my free and total testosterone in another 4 weeks?

Also I probably should go donate a pint of blood soon.

Testosterone, Serum 330 Low ng/dL 348-1197
Free Testosterone(Direct) 8.4 pg/mL 6.8-21.5
Pregnenolone, MS 22 ng/dL
Dihydrotestosterone 242 High ng/dL 30-85
T4,Free(Direct) 1.40 ng/dL 0.82-1.77
DHEA-Sulfate 204.7 ug/dL 71.6-375.4
Cortisol 11.9 ug/dL
TSH 2.150 uIU/mL 0.450-4.500
Estradiol 35.8 pg/mL 7.6-42.6
Roche ECLIA methodology
Prostate Specific Ag, Serum 1.3 ng/mL 0.0-4.0
Triiodothyronine,Free,Serum 4.2 pg/mL 2.0-4.4
Sex Horm Binding Glob, Serum 39.8 nmol/L 16.5-55.9

Glucose, Serum 92 mg/dL 65-99
Uric Acid, Serum 6.9 mg/dL 3.7-8.6
BUN 12 mg/dL 6-24
Creatinine, Serum 1.02 mg/dL 0.76-1.27
BUN/Creatinine Ratio 12 9-20
Sodium, Serum 142 mmol/L 134-144
Potassium, Serum 4.6 mmol/L 3.5-5.2
Chloride, Serum 104 mmol/L 96-106
Carbon Dioxide, Total 22 mmol/L 18-29
Calcium, Serum 9.0 mg/dL 8.7-10.2
Phosphorus, Serum 2.2 Low mg/dL 2.5-4.5
Protein, Total, Serum 6.5 g/dL 6.0-8.5
Albumin, Serum 4.1 g/dL 3.5-5.5
Globulin, Total 2.4 g/dL 1.5-4.5
A/G Ratio 1.7 1.2-2.2
Bilirubin, Total 0.6 mg/dL 0.0-1.2
Alkaline Phosphatase, S 73 IU/L 39-117
LDH 175 IU/L 121-224
AST (SGOT) 25 IU/L 0-40
ALT (SGPT) 45 High IU/L 0-44
Iron, Serum 47 ug/dL 38-169
Cholesterol, Total 192 mg/dL 100-199
Triglycerides 173 High mg/dL 0-149
HDL Cholesterol 41 mg/dL >39
VLDL Cholesterol Cal 35 mg/dL 5-40
LDL Cholesterol Calc 116 High mg/dL 0-99
T. Chol/HDL Ratio 4.7 ratio units 0.0-5.0

WBC 7.7 x10E3/uL 3.4-10.8
RBC 6.09 High x10E6/uL 4.14-5.80
Hemoglobin 19.1 High g/dL 12.6-17.7
Hematocrit 56.1 High % 37.5-51.0
MCV 92 fL 79-97
MCH 31.4 pg 26.6-33.0
MCHC 34.0 g/dL 31.5-35.7
RDW 14.6 % 12.3-15.4
Platelets 236 x10E3/uL 150-379
Neutrophils 66 %
Lymphs 20 %
Monocytes 11 %
Eos 3 %
Basos 0 %

Neutrophils (Absolute) 5.0 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.6 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.9 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.0 x10E3/uL 0.0-0.2
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

 

[CoastWatcher]

Okay so I got my lab tests back. Testosterone is low and converting to DHT like crazy since I am applying 200mg of 20% Testosterone cream on scrotum based upon my original doctor and matching this protocol:
http://www.hormonesolutions.com/blo...-times-more-effective-than-to-the-upper-body/

Clearly this protocol is not working and will have to change it. I am wondering if I should just give it another shot on normal skin? I see suggestions of 1/2 to 1 gram of 20% daily to normal skin, would that be correct? Then measure my free and total testosterone in another 4 weeks?

Also I probably should go donate a pint of blood soon.

Testosterone, Serum 330 Low ng/dL 348-1197
Free Testosterone(Direct) 8.4 pg/mL 6.8-21.5
Pregnenolone, MS 22 ng/dL
Dihydrotestosterone 242 High ng/dL 30-85
T4,Free(Direct) 1.40 ng/dL 0.82-1.77
DHEA-Sulfate 204.7 ug/dL 71.6-375.4
Cortisol 11.9 ug/dL
TSH 2.150 uIU/mL 0.450-4.500
Estradiol 35.8 pg/mL 7.6-42.6
Roche ECLIA methodology
Prostate Specific Ag, Serum 1.3 ng/mL 0.0-4.0
Triiodothyronine,Free,Serum 4.2 pg/mL 2.0-4.4
Sex Horm Binding Glob, Serum 39.8 nmol/L 16.5-55.9

Glucose, Serum 92 mg/dL 65-99
Uric Acid, Serum 6.9 mg/dL 3.7-8.6
BUN 12 mg/dL 6-24
Creatinine, Serum 1.02 mg/dL 0.76-1.27
BUN/Creatinine Ratio 12 9-20
Sodium, Serum 142 mmol/L 134-144
Potassium, Serum 4.6 mmol/L 3.5-5.2
Chloride, Serum 104 mmol/L 96-106
Carbon Dioxide, Total 22 mmol/L 18-29
Calcium, Serum 9.0 mg/dL 8.7-10.2
Phosphorus, Serum 2.2 Low mg/dL 2.5-4.5
Protein, Total, Serum 6.5 g/dL 6.0-8.5
Albumin, Serum 4.1 g/dL 3.5-5.5
Globulin, Total 2.4 g/dL 1.5-4.5
A/G Ratio 1.7 1.2-2.2
Bilirubin, Total 0.6 mg/dL 0.0-1.2
Alkaline Phosphatase, S 73 IU/L 39-117
LDH 175 IU/L 121-224
AST (SGOT) 25 IU/L 0-40
ALT (SGPT) 45 High IU/L 0-44
Iron, Serum 47 ug/dL 38-169
Cholesterol, Total 192 mg/dL 100-199
Triglycerides 173 High mg/dL 0-149
HDL Cholesterol 41 mg/dL >39
VLDL Cholesterol Cal 35 mg/dL 5-40
LDL Cholesterol Calc 116 High mg/dL 0-99
T. Chol/HDL Ratio 4.7 ratio units 0.0-5.0

WBC 7.7 x10E3/uL 3.4-10.8
RBC 6.09 High x10E6/uL 4.14-5.80
Hemoglobin 19.1 High g/dL 12.6-17.7
Hematocrit 56.1 High % 37.5-51.0
MCV 92 fL 79-97
MCH 31.4 pg 26.6-33.0
MCHC 34.0 g/dL 31.5-35.7
RDW 14.6 % 12.3-15.4
Platelets 236 x10E3/uL 150-379
Neutrophils 66 %
Lymphs 20 %
Monocytes 11 %
Eos 3 %
Basos 0 %

Neutrophils (Absolute) 5.0 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.6 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.9 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.0 x10E3/uL 0.0-0.2
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

That is a ridiculously low level to find your testosterone, no question,mans your estradiol was measured with the standard test (based on the reference range). Blood donations are in your future, no doubt.

You could certainly adopt the modifications you suggest, that might bring success. Or, you could accept the fact that topicals aren't working for you. In many men, I was one of them, they simply don't, no matter how much - or where - the gel or cream is applied. That's why so many of us here at EM inject.

 

[tomas]

Appreciate the feedback. I am going to start applying 1/2 gram to my shoulders and then retest again. If that does not bring it up I will try again and see if I can get on injections.

 

[tomas]

Does anyone know how long should I wait to get my testosterone retested after changing protocols for it to reach a steady state?

I will be trying the androgel protocol of application to the shoulders that is listed at
https://www.excelmale.com/forum/sho...-that-Can-Improve-Testosterone-Gel-Absorption

 

[Vince]

Does anyone know how long should I wait to get my testosterone retested after changing protocols for it to reach a steady state?

I will be trying the androgel protocol of application to the shoulders that is listed at
https://www.excelmale.com/forum/sho...-that-Can-Improve-Testosterone-Gel-Absorption

When changing my protocol, I wait at least 6 weeks.

 

[Dr Justin Saya MD]

When changing my protocol, I wait at least 6 weeks.

^^^This is good advice^^^

 

[tomas]

Two weeks applying 1/2 to 1g of 200mg/g cream to my shoulders and the body swelling has mostly receded but still some remains. No noticeable improvement in how I am feeling and libido seems to be worse than when I started the cream. Sinuses are swollen and I wake up not being able to breath through them. It really does not look like this protocol is working for me either but I will keep it up for another month to get tested again. I am off to get a phlebotomy tomorrow and that always makes me feel a bit better.

This seems to be the same scenario I had when I tried testosterone cream before.

What tests should I have done during the next round?
Free/total Testosterone
Estrogen sensitive

should I check my DHT or just leave it since it came up really high last time?

 

[madman]

If your testosterone cream is less than 10-15% that is your primary problem. Creams work good for some guys, as long as its strong enough. Otherwise it just converts to estrogen rather than raising your TT levels substantially.

Dead on I would say!