T Nation

Androgel Failed After 1 Month, Wanting to Switch to Cyp


#1


New to the board. Started Androgel 1.62% 40.5mg (2 pumps) daily last month. Both free T and total T numbers have dropped slightly.

I was told my LH and FSH values were moot since the doctor tested them after beginning therapy. Now I can't determine primary/secondary. I am attaching my latest CBC and CMP. Is cyp my next best course of treatment? Thanks.

46 yo, 6'3, 285 lbs, Type 2 DM, orals, A1c 5.1 Eating clean, carbs from vegetables only, walking 6 days/wk, free weights 3 days/wk.
PSA 0.5 (ref 0-5), T3 5.11 (ref 2.39-6.79), T4 1.01 (ref 0.45-1.40), B12 792 (ref 193-982) D 25-Hyd 42 (ref 32-100) before beginning TRT
Starting Free T: 38 (ref 47-244), Total T: 293 (ref 260-1600)
09/2014 Begin Androgel 1.62% 40.5mg daily
10/2014 Total T 157, Free T 36,FSH 2.0 (ref 0.7-11.1), LH 0.8 (ref 0.8-7.6), E2 26.8, DHEA 242 (ref 80-560).


KSman is Here
#2

You need ranges for your Total T and Free T.

You should read the sticky’s in the forum. on the main page:

Thyroid Basics
Things that Damage your Hormones
TRT: Protocol for Injections
Estradiol: Why You Should Care
Lab Work, Blood Testing and Symptoms
Finding a TRT DocD
Advice for New Guys

E2 should be a little lower (E2=22), also transdermal T isn’t absorbed effectively if one is hypothyroid. You should start taking morning temps upon waking and repor them here, under 97.5 is a form of hypo.


#3

Suspect that you have a thyroid problem. You can do these labs:
TSH
fT3 - this is what gets the job done inside your cells
fT4
T3 and T4 include amounts bound to thyroid binding globulin so these really do not tell the story properly.

However, there can be other issues that the above labs do not address. The bottom line is your body temperatures. See the thyroid basics sticky and check oral body temperature when you wake up and mid afternoon. See the sticky for temperature interpretation. Also note issues with long term need for iodized salt and/or vitamins that list iodine. You also need selenium in your supplements for proper thyroid function, as well as other trace elements, and chromium picolinate can help with insulin sensitivity.

If body temps are low, not enough fT3 is getting into the cells to regulate mitochondrial metabolism and your whole body slows down, reducing burn of lipids and glucose. So you can see where that goes.


  • hypothyroidism
  • magnesium deficiency - do you get leg cramps?

#4

Thank you for the responses and links.

@MUthrows94
The reference ranges are in parentheses with the lab value listed above.

@KSman
TSH from July was 0.86 (ref 0.34-4.82)
I supplement with a multi A-E, extra b12, ubiquinol, chromium GTF, magnesium, zinc, r-lipoic acid, CLA, NKO. I use too much salt but it’s not iodized. I have recently started taking selenium. I used to get leg cramps before taking magnesium (prediabetic, six or so years ago).

I will go over what you’ve listed about thyroid and will start taking body temperatures today. I had my metabolic rate measured a few months ago with a ReeVue Indirect Calorimeter respiratory test and results were ‘plus 20% fast’.

I f/u with doctor next week and will ask about fT3 and fT4. I will post body temperatures next week. Thanks again.

Checked my multivitamin (LEF 2-per-day): 150mcg per serving size 2.


#5

Your TSH isn’t terrible. Something that did catch mt eye was that you get your carbs from vegetables. You clearly have some other things to work out but I can’t stress enough that you do not want to drift into ketosis. Good carbs are your friend, and you won’t get them all from vegetables.
I would love to see a gel or troche success story. I haven’t yet. Good luck to you.


#6

46 yo, 6’3, 285 lbs, Type 2 DM, orals, A1c 5.1 Eating clean, carbs from vegetables only, walking 6 days/wk, free weights 3 days/wk.
PSA 0.5 (ref 0-5), T3 5.11 (ref 2.39-6.79), T4 1.01 (ref 0.45-1.40), B12 792 (ref 193-982) D 25-Hyd 42 (ref 32-100) before beginning TRT
Starting Free T: 38 (ref 47-244), Total T: 293 (ref 260-1600)
09/2014 Begin Androgel 1.62% 40.5mg daily
10/2014 Total T 157, Free T 36,FSH 2.0 (ref 0.7-11.1), LH 0.8 (ref 0.8-7.6), E2 26.8, DHEA 242 (ref 80-560).
10/2014 Begin testosterone cypionate injections 100mg weekly

I have switched from Androgel to weekly cypionate injections of 100mg. No noticeable effects quite so soon.

My body temperatures in the morning have ranged from 96.7 to 98.3. My afternoon temperatures have ranged from 98.0 to 99.2. Any benefit to adding iodine and at what dose? Any other supplement recommendations? Thank you.


#7

Your sporadic body temperatures indicate adrenal fatigue. Your low-ish DHEA-s also indicates that. Do you have any cortisol tests? Need to know what time of day taken also. I would run 24 -hour cortisol test.

I hope you didn’t buy into paleo/primal carbs are evil bullshit. Studies have shown that too low carbs over extended time will down regulate hormones, especially if you train.


#8

I have cut back on carbs in my diet in order to more closely manage my HbA1c and glucose levels. No breads, grains, or potatoes. If I consume these fast acting carbs, my glucose skyrockets and I feel exhausted. I try my best to keep my levels stable. Doctor mentioned DHEA should be in the 450-650 range yet did not suggest/prescribe anything to correct it, just the cypionate. He thought the 26.8 E2 was a bit low (??). He suggested I might need a referral to a specialist. I have not yet tested cortisol. I asked about needing an AI down the road and he seemed hesitant to prescribe one.


#9

E2=26.8 is not low and VS your T levels makes you estrogen dominant that further increased insulin resistance.

Your inability to absorb transdermal T also points to hypothyroidism. If so, metabolism is low and cells don’t burn glucose or lipids, that increases glucose …

In USA, DHEA is on the vitamin shelf.


#10

Ask your doctor for a sensitive E2 test.

I can’t say that I really trust the standard E2 test, as there has been a significant difference in my values between these two tests.