T Nation

High T Despite Very Low Dose Androgel

I am 24 and I’ve been on a low dose of Androgel 1% gel for a little over 3 years. I went on trt with levels around 275 ng/dl, w/ no sperm, insanely high LH, and pea-sized nuts. Through some experimentation, my doctor and I have found a way to maintain my levels at or around 1000 ng/dl by taking 1.25g/2.5 g every other day.

My first question is why if I am taking less than a low dose of Androgel (the low dose on the bottle is considered 5g per day), are my levels so damn high? My doctor cannot explain why I respond so well to the Androgel, says it’s an anomaly, and does not know whether I am making any T. I shouldn’t be, right, after three years on this? Do any of you have any insight? As I mentioned, my nuts are very small (pea sized).

My second question- is there a way to confirm if I still make any T without going off of the gel? My LH seems to be consistently low now, and SBGH was normal, but it’s been awhile since I had all my labs checked. I am curious because I am considering a cycle of some sort with injections, and/or upping my dose to achieve cycle-like results (probably less ideal), but I don’t know if it’s worth doing any PCT considering that my natural T may be shutdown anyway. I would guess it has been for awhile, but cannot confirm. My main hesitation with a cycle is I don’t want to prevent the possibility of achieving this equilibrium post-cycle because I am able to at least make slow and minor gains with my current T levels. Keep in mind that I am only considering a cycle, not necessarily planning to do one because I want to know what’s up with my body first.

My third question, should I get my e2 checked and possible consider an anti-estrogen supp rather than do a cycle? I don’t have any symptoms that lead me to worry about having high estrogen, but I read that Androgel is notorious for converting to estrogen. Also, maybe lowering estrogen will help my gains, but would it really make a big difference?

Sorry to lump so many questions and info together. Any response to any question is appreciated because it’s hard to find answers elsewhere, especially regarding the weird androgel response!

  1. no clue. you are definitely an anomaly. Consider yourself lucky.

  2. Highly unlikely you are making any endogenous test given the circumstances. What is your LH while on? If you want to cycle, this should be a very minor consideration and one that I wouldn’t concern myself with at all. You can’t run an AAS cycle with androgel.

  3. Yes to cheking E2–this is a must while on TRT. It has no bearing on whether or not you can blast/cruise. No it will not make a huge difference in your “gains”.

Thanks for the response! Again, I hate to ask all of this at once. I don’t recall the exact LH, but it was most recently low as in close to 2 or 3 U/L, still within normal range. Oddly, it has been higher at times while on the treatment, but never abnormally high. I will call clinic tmrw to see if I ever had e2 checked, and consider rechecking.

The cycle I am pondering would be T enanthate, 500mg for 10 weeks. Somebody is practically shoving this cycle down my throat telling me not to worry about it, but before I would start, I’d need to do more research on how I’d go about the transition back to Androgel, and also whether and how to use something like Nolva, given my situation. If I get more serious about this, I will probably create another post in the other Steroid forum. For now, because I’m not in any hurry, I’d appreciate any other responses.

The Androgel thing still bothers me because I am yet to hear of a like case.

[quote]VTBalla34 wrote:

  1. no clue. you are definitely an anomaly. Consider yourself lucky.

  2. Highly unlikely you are making any endogenous test given the circumstances. What is your LH while on? If you want to cycle, this should be a very minor consideration and one that I wouldn’t concern myself with at all. You can’t run an AAS cycle with androgel.

  3. Yes to cheking E2–this is a must while on TRT. It has no bearing on whether or not you can blast/cruise. No it will not make a huge difference in your “gains”.[/quote]

Did you ever get a pituitary MRI to rule out andenoma? My LH was not completely shut down when my values were in the 800-900’s range (dont remember where) so I had one done to rule it out. Came back clean, which was a sign of relief, so we upped my T dosage. If you don’t have andenoma, you likely just are meant to have Spartan-like T levels IMO. Ride with it.

You need to do far more research before doing an AAS cycle, but your initial plan is respectable. Learn all you can about it then post in the Steroid forum.

You will not do anything once you cease your cycle. Maybe take a week off completely from any sort of injection/gel, then start back up on your normal protocol. Your levels will fall back to steady state within 2 weeks or so.

Hmmm. Never had a pituitary MRI, but I had a CT scan 5 years ago (came up normal). Doc said LH levels might always be a little higher than expected because of my primary hypogonadism.

I wouldn’t be opposed to getting a pituitary MRI, though. Only concern is cost. A couple of unexplained symptoms I’ve dealt with in the past have been bouts of blurred vision, and excessive sweating, but I haven’t had these issues in awhile, and now I feel pretty much 100% normal aside from having nuts that do not work. Of course, feeling good is not always an indicator of what’s going on inside.

Thanks again!

[quote]VTBalla34 wrote:
Did you ever get a pituitary MRI to rule out andenoma? My LH was not completely shut down when my values were in the 800-900’s range (dont remember where) so I had one done to rule it out. Came back clean, which was a sign of relief, so we upped my T dosage. If you don’t have andenoma, you likely just are meant to have Spartan-like T levels IMO. Ride with it.

You need to do far more research before doing an AAS cycle, but your initial plan is respectable. Learn all you can about it then post in the Steroid forum.

You will not do anything once you cease your cycle. Maybe take a week off completely from any sort of injection/gel, then start back up on your normal protocol. Your levels will fall back to steady state within 2 weeks or so.[/quote]

Found out my E2 was 24pg/mL, so “normal,” but not necessarily optimal. That was back in 2008 on a different dose, so it would be good to recheck. It’s been 4 years since my doc has checked anything aside from T, SHBG or LH. I ordered my medical records today, and decided to go through Private MD Labs (vis-a-vis Lab Corps) to get several tests done, namely

Estradiol, Serum
Follicle-Stimulating Hormone (FSH)
Luteinizing Hormone (LH)
Testosterone, Total, Serum
Testosterone, Free (Direct), Serum
Complete Blood Count w/ Differential
DHEA, Sulfate

I am also considering a Human Growth Hormone test or IGF-1, which have been used in indicating pituitary abnormality.

a CT scan is not the same as pituitary MRI (with contrast). It would be worth it to rule out, IMO…

[quote]VTBalla34 wrote:
a CT scan is not the same as pituitary MRI (with contrast). It would be worth it to rule out, IMO…[/quote]

Thanks, it looks like the copay is cheaper than I thought. I might see if my PCP or endo will order it.

Here are my recent results after 1.5 years on the same dose.

CBC

WBC ~ 4.8 x10E3/uL Range 4 - 10.5 (a little low?)
RBC ~ 4.92 x10E6/uL Range 4.1-5.6 (OK, I think?)
Hegaglobin ~ 15.5 g/dL Range 12.5 - 17 (OK)
Hematocrit ~ 46.3% Range 36-50 (a little high?)
Platelets ~ 199 x10E3/uL Range 140-415 (a little low?)

Test, Serum 550 ng/dl Range 348-1197 (lower than optimal, but OK)
LH ~ 23.3 mIU/mL Range 1.7-8.6 (High, especially while on TRT, yes?)
FSH ~ 56.7 mIU/mL Range 1.5-12.4 (High)
Estradiol ~ 10.0 pg/mL Range 7.6 - 46.2 (Low end).

I also did Thyroid tests, everything was in range, so did not want to post (yet).

My thoughts/concerns:

CBC looked OK, but I just wanted to confirm. WBC/platelets a little low??

Testosterone reading is a little baffling because it was as high as 946 ng/dl with the same dose last I checked. It seems like my readings should not vary that much, but I realize there are several variables. I plan to retest, and I don’t mind doing this monthly if need be.

LH seems quite high for an individual on TRT. This makes me question the degree to which I’m taking in the T from Androgel. I don’t take anything that boosts LH. Once concern raised on another post is that I could have pituitary issues leading to high LH, i.e. adenoma, which I have yet to rule out.

Estradiol is OK as far as I know. Maybe a little low?

The next tests I plan to get are IFG-1, T (again), free T, and cortisol. I’m doing this all for my own curiosity, as I’m not really symptomatic of any major issues. I might do a pituitary MRI, but I probably need to have a doc order that and go through insurance. I’m mainly trying to figure out why LH is so high.

VTBalla already responded to this on another post (my mistake to post two threads) and he has been more than helpful. I am wondering if anybody else also has an opinion?

[quote]VTBalla34 wrote:
CBC stuff looks fine…I don’t know enough about it to say wha tis optimal or not, but anything within range is probably ok.

Estradiol is slightly on low side from what is routinely considered optimal, but not much you can do about that.

LH and FSH are very high for an individual on TRT. Definitely should have a pituitary MRI done. If its clean, up your dose of androgel as this is your body telling you it needs more T![/quote]

[quote]jimbo12 wrote:
Here are my recent results after 1.5 years on the same dose.

Test, Serum 550 ng/dl Range 348-1197 (lower than optimal, but OK)
LH ~ 23.3 mIU/mL Range 1.7-8.6 (High, especially while on TRT, yes?)
FSH ~ 56.7 mIU/mL Range 1.5-12.4 (High)
Estradiol ~ 10.0 pg/mL Range 7.6 - 46.2 (Low end). [/quote]

Definitely something strange is going on. TRT normally shuts down the HPTA, and your LH and FSH should be far below the normal range, not in range or above. Estradiol seems a little low and I guess the HPTA might be raising LH and FSH to try to raise it, but your levels are extremely high.

Are you taking any anti-estrogen such as arimidex, aromasin, etc.? If you are, you should probably stop and see if things normalize. If not, you should see an endocrinologist stat, since your extremely high levels could be symptomatic of a tumor.

[quote]seekonk wrote:

[quote]jimbo12 wrote:
Here are my recent results after 1.5 years on the same dose.

Test, Serum 550 ng/dl Range 348-1197 (lower than optimal, but OK)
LH ~ 23.3 mIU/mL Range 1.7-8.6 (High, especially while on TRT, yes?)
FSH ~ 56.7 mIU/mL Range 1.5-12.4 (High)
Estradiol ~ 10.0 pg/mL Range 7.6 - 46.2 (Low end). [/quote]

Definitely something strange is going on. TRT normally shuts down the HPTA, and your LH and FSH should be far below the normal range, not in range or above. Estradiol seems a little low and I guess the HPTA might be raising LH and FSH to try to raise it, but your levels are extremely high.

Are you taking any anti-estrogen such as arimidex, aromasin, etc.? If you are, you should probably stop and see if things normalize. If not, you should see an endocrinologist stat, since your extremely high levels could be symptomatic of a tumor. [/quote]

Thanks for the response, seekonk. I will look into an MRI asap. No, I don’t take any AI. If anything, I would think that upping my TRT dose could create more estrogen conversion, if it’s a big concern. I don’t see any reason to worry, though.

I should also note that while on TRT over the years, my LH was as low as 4 mIU/mL, but has varied a lot, in part as Androgel doses have varied. When it has been a little high, my endo has been OK with it, but I don’t think he’s ever seen them be this high. Also, he hasn’t tested FSH or E2 at all in the last few years. The recent tests I did on my own through Private MD Labs, in part because my endo clinic ordered the wrong tests for me last time around, and my endo did not want to test everything else. In short, I’m considering switching endos.

I’m a little concerned that it will be difficult to convince my current endo to do the pituitary MRI because he just saw me and thought everything was fine. I will certainly ask him, though. Just curious, might a PCP ever order a Pituitary MRI??? Or would they likely say “see your endo.” That’s also worth a try.

[quote]jimbo12 wrote:
Just curious, might a PCP ever order a Pituitary MRI??? Or would they likely say “see your endo.” That’s also worth a try.[/quote]

A good, competent PCP is always your best bet for any sort of TRT treatment over an endo. This includes pituitary considerations. Unless you are near death, endos are extraordinarily useless.

something definitely weird. That hormone profile looks like someone on HCG or a SERM, not like someone on exogenous test.

[quote]dhickey wrote:
something definitely weird. That hormone profile looks like someone on HCG or a SERM, not like someone on exogenous test. [/quote]

HCG actually suppresses endogenous LH…you are right about the SERM though.

[quote]VTBalla34 wrote:

[quote]dhickey wrote:
something definitely weird. That hormone profile looks like someone on HCG or a SERM, not like someone on exogenous test. [/quote]

HCG actually suppresses endogenous LH…you are right about the SERM though.[/quote]

Gotcha…For some reason thought HCG would show up as LH on a blood test.

[quote]VTBalla34 wrote:

[quote]jimbo12 wrote:
Just curious, might a PCP ever order a Pituitary MRI??? Or would they likely say “see your endo.” That’s also worth a try.[/quote]

A good, competent PCP is always your best bet for any sort of TRT treatment over an endo. This includes pituitary considerations. Unless you are near death, endos are extraordinarily useless.[/quote]

I set up an appointment with a PCP on Wed. I’m going to mention blurred vision as a symptom although I haven’t had that in the last six months. I’m also going to bring all of my recent bloodwork, and emphasize the high FSH and LH.

[quote]dhickey wrote:
something definitely weird. That hormone profile looks like someone on HCG or a SERM, not like someone on exogenous test. [/quote]

The only supplements I take are OxyElite Pro (thermogenic fat burner), multi vitamin, and 10g of fish oil daily. I also recently added more carbs into my diet and increased calories. Never tried HCG or SERM.

The only thing I can think of is that I switch doses of Androgel every other day (1.25g/2.5g). I doubt this makes a huge difference in LH/FSH, but I couldn’t say.

Concerning your high levels of T while on a low dose of transdermal, I’ve had the same result. I’ve been on Testim 1%, 50mg daily for about 8 years and my TT levels have consistently been between 800 and 1345 (Quest, 241-827mg/dl). I conclude, from all the info I’ve gotten here, that we are simply good absorbers. My most recent lab uses different ranges for T so I don’t yet know about those, but my lab from 11/2011 has TT at 1335 (241-827 mg/dL). I know this isn’t of any help with your other issues but just wanted to let you know I’ve had similar results from transdermal T. Good luck!

Concerning your high levels of T while on a low dose of transdermal, I’ve had the same result. I’ve been on Testim 1%, 50mg daily for about 8 years and my TT levels have consistently been between 800 and 1345 (Quest, 241-827mg/dl). I conclude, from all the info I’ve gotten here, that we are simply good absorbers. My most recent lab uses different ranges for T so I don’t yet know about those, but my lab from 11/2011 has TT at 1335 (241-827 mg/dL). I know this isn’t of any help with your other issues but just wanted to let you know I’ve had similar results from transdermal T. Good luck!