Hypogonadal: But With One Test in Normal Range?

[Wwhite]

I went on TRT in 2012, with one blood test showing total T at 226 (range 350-1150) and a second one a week later at 310 (same range). Because I took these tests a few days after a trip abroad, I wondered if the low results might have been due to sleep deprivation/jet lag.

In many ways I felt better physically on TRT gel, and did get total T into the 400's-600's, but after about a year I stopped to see if I could recover on my own. After three months without TRT, my total level was 384 (range 350-1150) and free T was 67 (range 35-140). I was feeling achy and fatigued, so decided to try TRT gel again. But while physically I felt fine, my libido wasn't great and I felt a bit too detached. (It seems crazy to complain about being "too calm," but that was essentially the issue.) So once again I tried to come off, and lasted for 4 months. I felt better mentally, my libido seemed about the same, but I did have lots of body aches, recurrent hot flashes, and fatigue once again. My blood tested at 580 total T (range 350-1150) and 8.6 Free T (range 7.6 - 26) . I thought I had turned the corner, given the total testosterone result, but wondered about the relatively low free T and the physical symptoms. A week later I tested again, and this time I was 340 total T (350-1150) and 6 free T (7.4-26).

So I've stayed on T ever since, feeling better physically and less well mentally. I've tried to convince myself that this is my permanent state of affairs as a hypogonadal 55 year old. However, I still wonder about that 580 total T result. I assumed it was an incorrect lab report, given my general pattern of bloodwork. But might it be possible that, after 4 months off Axiron gel, I was eugonadal, and simply had to deal with relatively low free T? (I'm currently working with a general physician, not an Endo, and have never used testosterone before the low blood tests.)

Walter

 

[ERO]

Based upon the number of guys here that started on topical T and switched to twice weekly injections, my guess is that you would feel better going that route. A Total T of even 580 is mid-range at best and certainly not anything wonderful.

My best advice - don't go to an Endo, go with a TRT expert like the doctors at Defy Medical. Almost all of the guys we see here that are having problems with TRT are using their regular doc or an Endo instead of a doc that is a TRT expert.

 

[Vince]

Wwhite, I agree with ERO, I think your testosterone levels are too low and twice weekly injections are great.

 

[Wwhite]

Thanks for your reply. Do you think that the lab test of 580 total T after four months of being off TRT was a fluke? 340 seems to be my norm when off TRT, but maybe that's because of relative lack of sleep. I wouldn't mind having 580 as my baseline, although I think the free T level that came with that result (8.6 out of a range of 7.4-26) was typically low, and it was this continued low free T that led me to resume treatment (along with symptoms that indicated low T.)

 

[Wwhite]

Thanks, Vince. I will look into seeing an Endo. (I had my annual physical the other day, and the GP said it was unnecessary to have a prostate exam. On the one hand I was happy to hear this (!) but on the other I wonder if that protocol applies to those on TRT. I asked the GP about this, and he said that as long as the PSA test doesn't raise any concerns, an annual prostate exam isn't necessary. An Endo might have a different view.)

 

[Vince]

Thanks, Vince. I will look into seeing an Endo. (I had my annual physical the other day, and the GP said it was unnecessary to have a prostate exam. On the one hand I was happy to hear this (!) but on the other I wonder if that protocol applies to those on TRT. I asked the GP about this, and he said that as long as the PSA test doesn't raise any concerns, an annual prostate exam isn't necessary. An Endo might have a different view.)

I get a prostate exam one a year, it's a relatively simple test ( finger up the A hole ) you cannot look at it so the doctor feels it but I'm sure you know that already, it would be nice if your doctor knew it.