T Nation

Overwhelmed Looking for Advice

I’m 39 I have been dealing with what i believe to be low T and have been for several years. I went to regular family Dr finally a year ago and had my levels tested. They came back at 488 im fairly fit for my age and worked out pretty intensely 3 times a week so he wrote me off saying I can obviously build muscle and 488 was not low. The main reason I believed I was low was due to E.D. Low drive inability to lose fat around my waist while being on a strictly chicken rice and broccoli diet. I eat extremely clean. Fast forward to this past janruary I have him test me again my levels are at 286 he writes a script for androgel 1 pump. I took it for a month make him retest and im at 295. He then tells me to increase to 2 pumps. I did so for about 2 weeks then i decided to go for 3 pumps after feeling no different I did 3 pumps for a week then started experiencing very bad anxiety and panic attacks started having crazy ups and downs and wanted to crawl out of my own skin type feeling. So i decided to stop using it. I experinced the same type feeling for about 4 days then it went away. So my questions are is this normal to experience panic attacks and extreme anxiety and depressed feelings from androgel also is a 200 drop in one year an indication of something more going on. I have an apointment with a urologist the 17th and Im half scared to get back on trt after that experience. I found this site while i was searching all over while dealing with the symptoms a couple weeks ago. I have been reading as much as i can on here trying to learn as much as i can but theres so much info its overwhelming. Any info or advice is appreciated. What should i look for and ask the urologist. Thanks in advance

You should probably look for a TRT doctor, one who specializes in this and by that I mean they only do hormone replacement/restoration therapy. The gels are the least effective method of TRT.

A thorough initial lab workup would include at least the following labs:
CBC
lipids
CMP
SHBG
total testosterone
free testosterone
FSH
LH
prolactin
estradiol
DHEA-S
IGF-1
TSH
free T4
free T3
VitD

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@magneticstang…I’m literally going through the same thing, probably a little less healthy than you but I’ve been working on it.

Doc started me on androgel 1 % 2 pumps per day, got major anxiety even before I took first dose because my cholesterol was very high, but I took it after a call back from doc. It was about a week before I saw improvements, lasted about 2-3 weeks (couldn’t stay off the wife :wink: then crashed, went to 4 pumps, then 6, and now I’m at 8, same thing every increase. I went from 210-198-118-152-226 my last lab was mid 300’s but still feel like Garb.

Just started a thread yesterday and all responses I got were to switch to Injections. I’ve been lurking on the forums for a few months and it’s pretty unanimous, injections are the way to go. Just thought I share my experience with you, same age, same Rx, same symptoms. Hope you find relief soon.

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Androgel is garbage, a lot of men barely get levels elevated above pre-TRT levels. You need to look for a TRT specialists in anti-aging or sports medicine because there are few doctors in sick care (insurance network) who specialize in TRT.

If in US, you might consider Defy Medical which is a telemedicine clinic who specialize in this area of medicine.

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Ok thanks. I was refered to a urologist and he was a total dick. Made me feel like i was doing something wrong and i didnt need to be on it. He basically said my regular dr was a moron for just putting me on trt instead of figuring out why my levels dropped 200 in a year. That was basically what started the bad anxiety. Not sure if it was coincedental or not. I was there trying to see about injections actually because i wasnt getting anywhere w the gel. I felt great for a while but after a month or so i started feeling even more tired than before and by night time i was super irritable and tired even more than prior to the trt. I asked to be refered to a different urologist and he refered me to a place here in central illinois that looks to be their number one focus is trt judging by the website so hopefully they know what they are doing. I have an appointment the 17th so i will see how it goes.

Ok great i will screenshot this and ask for these tests. Thank you

I feel for you man. Its not fun especially when you feel like you have to know more than the doctors to get the proper treatment. I went off the gel for 24 hours and had just seen a urologist so he had put in for labs and i decided to go get them done even though i was off the gel for 24 hours and my levels were 168. I assume due to my natural production dropping. Good luck to you i hope you get it figured out.

I went to my appointment with the urologist today. I explained my situation from the beginning 488 test a year ago to 286 1 year later. My labs were 160 24 hours after stopping androgel. Which he said was due to me crashing my natural test which i already knew. He said he’s not convinced I have low T. And Shots would most likely make the anxiety and panic attack worse. How he can say im not low T is beyond me. I asked why my levels dropped 200 in a years time and asked if he thought that was normal. He said it could be dropping and its not normal. He said to wait until the end of may for new tests to let my natural test have time to recover. He said shbg test wasn’t necessary but agreed to estradiol test and a bunch of others. Then he said he was more of a specialist in hrt and his partner Dr Banno was the trt specialist and wants me to have blood work and then a consultation with Dr Banno which is who i requested to start with but they refused. Why does getting help and answers have to be such a pain in the ass and so frustrating.

Welcome to the US medical system. Anyway, he is trying to do right by you. The guy that you didn’t like had a point, it’s always good to figure out we your levels crashed before simply treating the symptoms.He’s probably a very good doctor. Treating low T by supplementing T is not the first step, it’s the last step once you have failed to get things operating correctly on their own. The new guy just wants to have lab work he can trust, which is also not a bad thing. We all want things fixed yesterday, but sometimes patience brings the best solution. Every guy on TRT would happily go back to normal natural production if that were an option.

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What a strange thing to say. HRT= hormone replacement therapy that is T E and P
TRT is just T Here’s hoping this Banno guy knows something.

HRT is probably referring more to treatment of women and/or gender reassignment

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The guys in your first post above responded “get a trt doc”. You are wasting your time. This response of yours is why. Just trying to be helpful.

We’ve been there done that and you should try to hear us out. If you had found a trt doc you would not be dealing with this. We know all to well how uneducated they are on this topic. Continue with this sick care system and you’ll continue beating your head against the wall.

Go spend the money on a good private doc and get fixed without having to decipher the BS.

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Thanks for the replies. I agree I would like to figure out pre trt levels then go from there. And I think thats exactly what he means by HRT is women’s hormones. I am not opposed to going out of “sick care” and to a clinic but i want first see how this goes with the new doctor. I at least asked what their typical protocol was and he said they typically do weekly injections so thats at least a step in the right direction. If he had said monthly or every 2 weeks i wouldn’t of prolly even went to the consultation after reading on here. Im going to wait til the end of may and see what happens. He put in for pituitary tests to make sure thats ok too. I have been in a couple bad accidents so who knows. I know i live like a monk so lifestyle is prolly not the issue unless its sleep or possible over training. Idk.

Even though everyone is probably right about androgel sucking. One thing to keep in mind if you get back on TRT is it takes time. You stated the first post that you upped dose, did not feel different and upped again on your own after 2 weeks. It takes longer than 2 weeks for changes to take place so really need to ride things out and then make adjustments. Give adjustments at least 6 weeks to level out (it may be a roller coaster), evaluate how you feel along with new labs and make then make educated adjustments. Good luck brother.

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Not everyone here things androgel sucks. I loved Testim 1% gel it got my 173 natty to 630 on 1 tube a day. I had to go to injections do to cost. Testim 1% gel is 300 dollars for a box of 30 tubes.

When I changed docs I tried 20% T cream (1 click on balls 3 on ribs) and that crap really sucked. 4 clicks of 20% cream got me to 350 after 3 months. It was 60 bucks a tube. T cyp injections are 130 for 10ml and that gets me about 2 months.

You sir at least have room to talk shit on cream as you have used it. I personally like it. That is why I did not come straight out and say testo sucks as I personally have never used it and do not feel like I can. Except on the big pharma price, that does suck.

The cost is ridiculous. Androgel is 575 for a pump bottle and thats 60 pumps so starting dose of 2 pumps a day thats a month supply. With a online savers card lts $200 which is a lot better but still pretty pricey especially if you arent absorbing much. After 4 weeks I was 295 up from 280 but I also didnt rub it on the morning of the test so im not sure how much one pump would of made a difference to those tests. I wanted shots from the beginning but the doctor said it was a last resort for some reason. From what i have read androgel converts to estrogen easier. Maybe thats where the anxiety issues came from all the sudden. I for the most part felt ok on it except for at night.

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These were the labs that were taken 2/1/2018.

This was all he checked 1/14/2019 right before i started the androgel

This wouldn’t be the first time I saw a TSH <2.5 and Free T3 bottomed out or suboptimal. TSH isn’t a good marker for thyroid function, free thyroid hormones are.

You need to supplement Vit D.