T Nation

Androgel Since My Early 20s


#1
  Editing this now to get more to the pointâ?¦  I've been on androgel for about 12 year. I"ve come to the conclusion, that all I have really done, is successfully shut my own production down to a trickle. After years of "having a small blatter" this past winter, it got out of control, and I went to the doctor, who said my DHT is probably high from TRT all these years (suddenly noticed my hair thinning bad too) Insurance questioned Fanastride, so a sonogram was done of my prostate, which showed it is in fact enlarged. Once I took a pill my prick died for a week. This TRT is looking worse and worse.


  I started researching like crazy, because permanent impotence was not a fun option.  Read on estrogen dominance, and DHT causing BPH, and found so much on NATURAL PROGESTERONE. I did find a forum here where some guy was trying to use Progesterone as an AI, and knew that wasn't right. I believe someone also said on here that Progesterone is a "nasty hormone"â?¦ from what I have researched, I can't really find a bad thing about it, and have been using it now for about 10 months. I know it has helped my BPHâ?¦ At times now, I can literally have a flow at least twice as long as I was before, and have to go half as often. My sex drive feels only stronger on natural progesterone. However, I'm exhausted all the time now! I gained like 15lbs in the last 6 months, and have no ambition at all. I crave chocolate all the time, and know my poor eating habits are killing me right now. 

  About 6 weeks ago I called my GP, and asked to go on 3 pumps of 1.62% Androgel (been on 2 pumps forever) My Total T was 376 when it was tested in June, and my joints have been feeling like I'll hurt myself if I do anything more than sit on the couch. I was active during the summer, and my knees were also really bothering me for the first time. So I started the 3 pumps. Maybe in my head, but in a few days my knees felt better, and i felt better overall. I thought I finally figure this out.  I was wrong. IDK if this is possible, but after 5 days of 3 pumps, I felt a tightening in the front of my scalp where my hair is suddenly thinning, and I started with the frequent urination againâ?¦ that all increased, and by the 10th day, i was pissing like every 20 minutes, so took a day off and back to 2 pumps, and back to researching. 

  I go into more below, because i spit out the story of my life, but long story short, I've been to my GP and ENDO, and a urologist, and collectively they know jack squat about TRT. I assumed one of these 3 doctors would know something! So it took me a long time to find out that transdermal T raises DHT more than any other form. This would have been good to know like 10 years ago! I never had a big problem with libido, so I wouldn't have chosen or continued with gel obviously. Shortly after that discovery, I found this site. That KSman and his stickies, put so much into prospective. I get a big sense he knows his stuff, since I already came to many of the conclusions he has.

  I See my GP in a week, so the game plan is to get on twice a week, or EOD SQ T-Cyp shots. My GP is actually pretty good.  I probably drive him nuts, but he is openminded to alliterative meds, cares, and doesn't pretend that he is the end all of knowledge if he doesn't know the answer to something.

  The questionsâ?¦..

1) How much T-cyp per week should I be looking for? (even gel has gotten me high, I don't wanna go too high, because I'm gonna try to go with no AI, since I'm sure that will be a battle to get, and wanna wait to see what it does to my E2 first.

2) How important is HCG? since I don't think I can even get it legally in the state of NY, I'll probably continue to go without it. I'm 34 years old, and think I want to have kids, and know I don't want that option taken away. 

 3) I know and don't doubt from lots that I have read, that E2 should be in the lower 20s for most. If we go on an AI, shooting for 22 sounds great, but at what number is it worth going on an AI? My E2 was tested ONCE by my therapist in January 2013.. and it was 35 range <or=39â?¦ I felt like crap then too, but would frequent shots bring that down possibly? if it gets into the high 20s, is it still worth an AI to get lower?

 4) I just started to take some Iodineâ?¦ the pills are 3mg says 2,000% How much should I take? I was told my thyroid was on the lower side, and have been checking my body temp. It has always been low and so is my sister's and father's. On average I'm below 97â?¦ if I feel I have a fever and am sick i'll be at 98.6.  this morning when I woke up i had the lowest reading ever at 94.5â?¦. Retested and got 94.9.

Over the counter meds includeâ?¦
Nettle root, DIM, Tocotreniols, MSM, fish oil, D3, B12, Super c complex with Bioflavonoids, "GTA-Forte" (doc gave for thyroid) and passion flower to sleep at night.
My RX meds are Lorazapan for sleep at times, but usually I don't take it unless I really have to, and for my ADD, Adderall and Vyvance which are both amphetamines. I also have a cream of 10mg Natural progesterone, and 30mg Chrysin I use at night.

The amphetamines both worked wonders a year ago when I was feeling good, but now, i hardly take them, because they just make me feel stressed, because i'm just so off, this past year really. It's like the lights are on, but nobody's home. Major brain fog. I've always had social anxiety, but have always dealt with that, but now I don't even have any desire to leave the house any moreâ?¦ work, sleep, and eat, even when I'm not hungry.

   I'm gonna just stop here, and leave my last 2 blood works, even though nothing we look at in TRT is really done.  I should have real test in a couple weeks.

7/22/2013â?¦. (they did the wrong test, so all we got)

T4 Total 7.7 (4.5-12)
Progesterone 1.0 (<1.4)
Total T 376 (241-827)
TSH 3.46 (.40-4.50)
PSA total 0.6 (0.0-4.0)
Total estrogens 73 (130 or less)

1/17/2013â?¦ (this was the most blood work ever done, and the only E2 test, and was ordered by a therapistâ?¦ tested like everything, but I'll just list the important, or what could be important)

Hemoglobin 16.5 (13.2-17.1)
Hematocrit 48.4 (38.5-50.0)
Platelet count 196 (140-400)
T4, free calc 2.34 (1.4-3.8)
Hemoglobin A1C 5.1 (0.0-5.6)
Estodiol 35 (SHBG 42 (10-50)
Progesterone 0.7 (<1.4)
T3 free 3.5 (2.3-4.2)
DHEA Sulfate 396 H (110-370)â?¦. Something to worry about?
PSA total 0.8 (0,0-4.0)
Prolactin 8.4 (2.0-18.0)
T4 total 7.7 (4.5-12.0)
T3 Uptake 31.5 (22.0-35.0)
FSH 0.9 L (1.6-8.0)
LH 0.3 L (1.5-9.3)
TSH 2.37 (0.40-4.50)
T4 Free 1.3 (0.8-1.8)
Thyroid Peroxidase AB <10 (<35)
Testosterone, total 571 (250-1100)
Free Testosterone 73.2 (46.0-224.0)���.. only time I can tell Fee T was ever tested on me
Bioavailable Testosterone 150.6 (110-575)
DHEA,LC/MS/MS 614 (61-1636)
Estrone 40 ( <68)

Any questions please ask, and thank you so much for any advice that I can get about how to get myself and my doc in the right direction!

YOUR WELCOME TO READ THE REST OF THIS. IT IS JUST A LITTLE MORE DETAILED VERSION OF HOW I GOT TO WHERE I AM NOW.

==================================== ==================================

THIS IS KINDA MY WHOLE STORY, SORRY.

 Hello all, Thanks in advance for any help and advice I can get. Not sure how detailed I should be with this, and don't wanna write a novel, but perhaps the background is important.

  I'm 34 years old, 5'10, 185lbs... waist is about 34 inches, I think. I am sometimes muscular, but feel pretty gross lately.  I carry my fat in my stomach and some in my chest, I don't think I'm at the point of man boobs though. I have what I would call all the traditional body hair... can grow a beard, chest, stomach, legs, some starting on the shoulders where I put the stupid gel.

  I've never been a very "manly man" in the sense, that I've never been really competitive, impulsive, or aggressive.  'andrenalitis' a term i heard in a beer commercial once, when a bunch of guys are watching football, the team scores, they all go nuts, and the one guy in the middle sits, relaxed and says an unenthusiastic, yah...Well, I'm that guy. 

  At 12 years old, I started lifting weights, reps of 10 or 15... no real heavy training really. Felt the changes in my body, lifted 3 days a week, and would never miss a work out. I'd always see good gains, with little effort really. I went through puberty as most would... about 17 or 18 would be my peak... in a sense, it has been all down hill from there. I can remember benching 235lbs 10 consecutive times in high school. The football coach was not pleased, that I wasn't interested in playing, and to be honest, it was mostly because even then, any hard training would seem to burn me out and make me lose muscle and strength. In my late teens, there were ups and downs. I had a tendency for laziness and my body could always change fairly dramatically in a short period of time. Muscles would wither away, but if I got in a few good workouts, they'd be right back up. By my early 20s, my energy was low, no longer felt like working out, my libido wasn't as strong (since I was 12 or younger, I was hornier than I would ever want to be, especially since I had no confidence to talk to girls anyway) what made me seek help was that, even if i would force myself to workout, I couldn't even get pumped up anymore. My Father was recently put on androgel, so I went to my GP and got my T tested. It was like 390, then a few month later tested like 32O, then a few month later 280. 

   My Doctor did, at one point before starting TRT, say my Thyroid was on the lower side of normal, and with my symptoms, put me on a med.That got me feeling really good, but then, back to normal. He raised the dose, because on the med, the test actually came back low for real.... felt good, then couldn't sleep and felt shaky, so I stopped all together, and things just went to crappy normal again.

   I've been taking ANDROGEL for secondary hypogonadism since around 22 years old. I wasn't seeking out TRT, and tried some herbal things, that the doc recommended first and tried to just be healthier, to see what happens. No Dice..  I am 34 now. All the classics happened... I felt amazing on 4 pumps of 1% gel for a few weeks, then, just as bad or worse, new blood work said T was low, and he put me on 6 pumps. Felt amazing again, and was on that dose for 8 or 9 years! I might have been tested for total T once in the beginning of that dose, and it was probably ok. I did lose that amazing feeling fast, but felt "OK" and knowing nothing back then, just kept going with no blood work. Eventually I felt like total shit, and figured my T was low again, so i had blood work done In 09/1/2010... To my surprise my T was at 1339 (241-827)... "Apparently High T does't feel good either" I thought, knowing nothing back then... would love to know what my E2 was, but, no reason to test for that of course (sarcasm)... Doc brought me back to 4 pumps and I started feeling better, never great. 

  So, I go to an endo... he wanted a baseline... I think he only had me stop for a couple weeks, but cant remember. He said I was young to be on that, and we should look into why my T was low. (good of him) Blood work off T for a short time 6 weeks at most, since the test date is 10/12/2012... (All blood work I have ever done is from quest)

FSH 3.3 (1.6-8.0)
LH 3.4 (1.5-9.3)
Total T 220 (241-827)
Prolactine 5.6 (2.0-18.0)

T4 free Calculated 2.16 (4.5-3.8)
T4 total 6.5 (4.5-12.5)
T3 uptake 33.3 (22.0-35.0
TSH 3rd generation 2.53 (0.40-4.50)
Thyroid Peroxidase AB <10 (<35)

The endo also did an MRI on my pituitary gland that came back normal. There was a lot of other blood work, but no free T or E2.. We never wanna check that I guess. So I'm told to just go back on the androgel. I asked to stay off of it for awhile to see how my body would respond, I liked to think that over time my balls would start to work again. The endo agreed. So for over 5 month I stayed off... 3/17/2010...

Total T 90 (241-827)

Back on gel for 8 days 3/25/2010

Total T 335

At some point my GP put me on the 1.62% 2 pumps per day

7/26/2012

Total T 448

 I've had ups and downs over the years, but have generally been idling through life feeling older. I've had stress related ED a few times, but most of the time have a pretty strong sex drive, and except a few times with the stress related ED, I can generally perform every day, the enjoyment of sex, is not as consistent. interestingly enough, my Junk worked better with a T of 90, than it did with a T of 1339... I probably felt the same really.

 Over the years I was taking Lorazapan for my anxiety, mainly just to sleep at night though. I really try not to take anything could end up being dependent on. My Doc, might have gotten a little heat for prescribing that to so many, so he started sending people to a therapist. I figure why not, I could talk to someone... So I go to her around 11/2011. She doesn't do too much talking really... I believe she just figured out a cocktail that makes people feel good, so she gets me on Two different anti seizure meds... Lamictal and Trileptal...I read these are used off label for bipolar, but I'm quite the opposite. My mood is very low and steady. Anyway, I'm not all sure that I noticed anything, but maybe a little better. (Don't forget a dose... you could have a seizure now that you are on these) After giving me the ADD test, and although I believe this to be a very over diagnosed condition, I do believe I have it. So she gives me Vyvance and Adderall... Well, that did the trick for me!  I was loving life! I would start big projects, and actually finish them, look forward to doing thing, and be able to go all day. I joined weight watchers around the same time, and with the help of them pills, I lost 30 pound in like 4 months, and never looked or felt better. I was down to 172lbs, and for the first time in my life saw stomach muscles! I was very active, but wasn't even working out, and felt like i was still strong, and lost little to no muscle in that weight loss. I was careful though.. I was eating, and made sure not to take the adderall or Vyvance all the time, and not if I felt i needed to rest. I still felt good for that summer, but a problem with the amphetamines was that I had to piss all the time.

 In 11/2012 I went on the night shift at work... Huge mistake! That messed me up so bad. I wasn't taking the Amphetamines as much because I didn't know when I would sleep. It really killed me!  I went down to 167lbs... but not in a good way. By now my frequent urination, was getting much worse, even without the Adderall, and I would have urgency problems!  I almost made a decision to either piss my pants, or just take it out in the parking lot with no cover anywhere in broad daylight. But then I got in my car, and it went away. This was all getting worse, and I came to the realization, that I lost like half or more of the hair in the front portion of my head! There were no signs of loss at all a few years earlier, so even though it happened gradually, as to not pin point a time, i feel it happened very sudden. I know guys can lose hair, throughout, but if you make it to 30, thick, you probably shouldn't feel like you are going bald over night :/ 

  I went to my GP... I didn't even mention both problems at once, and at the time, didn't even know there was a connection, but he said, "Well, that's DHT, from being on T so many years", and gave me Finasteride, and told me to take one MWF, or something... I asked and he did mention sexual side effects... I did a lot more reading.  I wanted it to work for me, but I toke one pill, and Had no movement for a week, which brought me to the conclusion, I'm gonna have to figure something else out.

  I was sent to a Urologist.  Peace of work!!! I mentioned that I was reading about hormone balance, and Estrogen problems and he lectured me for 5 minutes on how i don't have a degree, and he does, and he doesn't like patients switching doctors. As for blood work and hormones, he said, if you are on TRT, we look at your total T and your free T, and that's it..... I guess he is the best so far, since no one else is checking my Free T.

  Needless to say I never went back to him, and I've decided to be on my own, and work with my GP, who is actually pretty good.

Thanks for reading


KSman is Here
#2

Thanks for posting your story! I recently discovered my Testosterone levels are low (total 382ng/dL, free 8.3pg/mL), DHEA levels are 505.7ug/dL.

I’m wondering if I should see an endo? I’ve been having issues with sleep for most of my 20’s and teens. I’ve also been experiencing some gynecomastia (for several years) and general exhaustion. Reading about your experience really has me fearful of needing TRT but based on my symptoms Idk.


#3

You should not have AI avoidance. You need lower E2 levels.

You have functional hypothyroidism. You have read the sticky, done labs and checked your body temperatures.

Can you please talk about your long term use of iodized salt? Your iodine intake is a very important data point. ********************

You probably need to do some serious iodine replenishment. See the sticky. If you cannot restore your body temps with IR, then you will need some Rx thyroid meds. Best to try IR before a lifetime of Rx thyroid meds.

If you have mid range or higher fT3 and lower temperatures, your fT3 may be getting blocked by rT3 and you can get a lab for that. See references to rT3, Wilson’s book, adrenal fatigue in the thyroid basics sticky.

Poor response to T-gel:

  • one part of this is that thyroid problems often are associated with poor absorption
  • and we know that TRT can not work out well in some cases of hypothyroidism as ones metabolism cannot keep up with the effects of T trying to increase your weakened metabolism

BPH is as you have read, worsened by E2 levels. This is not something that progesterone can resolve. You need an AI. Lower E2 will also improve many aspects of your mood and brain function. Progesterone can help with cortisol levels and sleep for some.

Suggest that you try the standard injected protocol.
100mg T cyp per week, inject twice per week, use insulin needles and inject over legs IM or SC as you feel more comfortable with.
1.0 mg anastrozole per week, take 1/2mg at time of injection
250iu hCG EOD SC [NY cannot ban a particular drug]
Adjust T to get to high-normal TT and FT
Keep E2 in lower 20’s, adjust dose via calculation in advice for new guys sticky

If you get T and thyroid addressed, your mood, energy, sense of well being and libido will improve a lot and you should be able to loose weight easily.

Get on injected T, lower E2 and DHT
Lower E2 as needed with anastrozole
Fix body temps with iodine and/or Rx thyroid meds

You can ask to try trazodone for sleep. Very inexpensive. Search this forum for what I have written before.
Melatonin 5-6mg time release will help you fall asleep. Must be time release. On the shelf in pharmacies or where vitamins are sold.

Do a AM cortisol lab -at *AM.
T, thyroid and cortisol status all need to be good.
ADD meds may be affecting cortisol and adrenals.

Get IGF-1 lab, to evaluate GH levels.

See where DHEA-S goes after all of the above.

If your thyroid enlarged, lumpy or asymmetrical?
Have docs examined your testes?

Have you read the finding a TRT doc sticky?