Got Test results after 3 months 1% T-Gel . . . very rattled!

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Melody68

New Member
I'm 68 and was diagnosed in December with lower T at 314, hematocrit at 47. I decided together with the Endocrinologist to go with his suggestion of 5gms 1% T Gel, the regular starting dose.

Fast forward to my first blood test taken yesterday after applying the gel regularly for 3 months. And my results are . . . 167 with a hematocrit of 50! That sounds pretty CRAPPY, and pretty shocking . . .

How do I feel? None of my low T symptoms have improved; the only things I feel at all are slightly sensitive nipples, a scrotum that seems tighter, and despite increased exercise and a modified diet, I haven't been able to lose any weight (in fact it's increased a few pounds).

How can this be? Maybe it's a lab test error? Maybe I don't absorb it well? But then how could my hematocrit go up? Help, really need some suggestions here . . .
 
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Systemlord

Member
Maybe I don't absorb it well? But then how could my hematocrit go up?
You’re supposed to run labs 6 hours after your dosing. Due to the short half-life of testosterone gel, levels will peak and drop rapidly so lab timing is critical!

Your trough levels seem a bit low, which suggests either your dosage isn’t high enough and/or you aren’t absorbing enough.

Why are you waited 3 months to draw labs is beyond me, because your levels should have stabilized after only 3 weeks.

Your endocrinologist is dropping the ball!

Endocrinologist’s are typically bad at TRT.
 
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Melody68

New Member
I normally apply the gel at 9 am. His office said I could have blood drawn at 8 am, making it 23 hours since the last testosterone application. Could it vary that much in a 24 hour period? There was some literature on here recently that suggested Testosterone peaks 2 hours after application and then settles down to a relatively constant level soon after that. Maybe not?

Yes, I agree with you, waiting 3 months seems too long, but who am I to criticize the endo?
 

Melody68

New Member
I've been thinking more about this. Could it be that someone like myself, after 3 months on T gel, would have 400 when the lab draws the blood 6 hours after gel application and then have it drop to 167 twenty-four hours after application? Could it really vary that much from peak to trough?

My endo, in addition to waiting 3 months before doing the first lab test, only requested a CBC and Total Testosterone count; there were no other tests like free testosterone, estradiol and estrogen, PSA etc. Is that cause for concern?
 

Systemlord

Member
His office said I could have blood drawn at 8 am, making it 23 hours since the last testosterone application.
That's wrong, you can be assured your doctors office, and doctor don't know what the hell they're doing! The half-life of T gel is 4 hours. I'm on Jatenzo, a new oral testosterone undecanoate with a half-life of 6 hour (PK profiles below), and I see a 100 ng/dL drop every hour and I dose twice daily.

Jatenzo peaks in 2 hours.

TRT is a field of medicine that few doctors truly grasp, the majority get it wrong and many doctors who learn about pharmacokinetics in medicine school fail miserably in the clinical setting.

Often doctors are into other fields of medicine and don't spend much of their time dabbling into TRT.

There's an old saying, if your medical problem isn't in your doctors top ten greatest hits, your experience is likely be a negative one.

My endo, in addition to waiting 3 months before doing the first lab test, only requested a CBC and Total Testosterone count; there were no other tests like free testosterone, estradiol and estrogen, PSA etc. Is that cause for concern?
Of course it is a concern because TT doesn't drive effects of TRT, the FT drives symptom resolution and the metabolites estrogen and DHT. It's too early to be testing for PSA. The sick care system is not a good place to get treatment for low-T, because your doctor works not for you, but your insurance company.

The doctor answers to your insurance company, and as long as that's the case, care will be substandard. A lot of guys pay out of pocket to get better care.

This is the kind of mediocre care you can expect from a sick care system.

after 3 months on T gel, would have 400 when the lab draws the blood 6 hours after gel application
Your dosage isn't high enough, you should be higher at your midpoint! On top of that you need twice daily dosing.


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