T Nation

Question on Androgel TRT

Over 35 Lifter
#1

My test was low, 350, free test was actually kind of high.

Anyway, doctor wants to put me on androgel. I had hoped for the subQT test self inject, ai and hcg, but no luck. try this first.

Anyway, what I don’t get, my question is that doesn’t androgel just suppress you 1 for 1? IE isn’t your own production lowered by the amount of androgel you take, rendering it useless?

My doc didn’t seem to understand the question, he was kind of like “no, no, we want to raise this 350 to the 500s, so that’s where androgel comes in”.

Why do people use this stuff at all then if it is just 1:1 suppression? Unless they’re taking more than they produce naturally.

I’m thinking of an AI TRT only, but someone on here mentioned that wouldn’t work. My E was 35 or 37 on a 0-53 scale.

#2

Here are my results, fasting am test.

I posted them in another thread but will repost them since this is a new question.

glucose 83
chol 258
trigly 351
hdl 42
vldl 70
ldl 146
ldl/hdl 3.5
test serum 321 (241-827)
test free 16.76 (5.00-21.00)
% free 5.22 (1.5-4.2)
lh 4.1 (1.5-9.3)
fsh 2.9 (1.4-18.1)
igf-bp3 6.0 (3.3-6.6)
tsh 1.66 (.45 - 4.5)
tyroxine (t4) free, direct 1.03 (.93-1.71)
igf-1 187 (101-267)
estradiol 35 (0-53)
dehydroepiandrosterone sulfate 109 (95-530)
prolactin 5.6 (2.1-17.7)

#3

Your DHEA is low and your cholesterol is not. This suggests weak adrenal function, but hard to be specific when you do not state your age. Suggest that you take 50mg/day DHEA, better with a fatty meal.

Your FT upper range should be more like 36. Your FT level is not good, that %free looks bogus.

Your E2 is too high, lowering to near serum E2=22pg/ml could increase T levels.

Your TSH looks good, but your T4 looks a bit low. Note that low thyroid levels are associated with inability to absorb T transdermals.

All TRT is repressive. After you shut down the HPTA, then more T leads to higher T levels. You cannot augment T with TRT, it is T REPLACEMENT therapy.

If you have E2=35 now, TRT will take that higher. You really need a AI before TRT and an AI will be essential with TRT.

LH is released in pulses and the specific level is really lab timing. We see that it is non-zero, so LH is there. FSH has a longer half life and is a better measure of gonadotrophin levels that LH. When you look at where your FSH is withing its range, that does make sense relative to TT in its range.

Are you paying out-of-pocket for t-gel or insurance pays. T self injections are least cost and very effective level wise, when injected frequently.

#4

I’m 42.

I realize T self injections cost is lower, but he said to “try this first”.

The reason I ask is he seemed to be like “we just need to raise this a bit” so he put me on like 1/2 pack or something of androgel. It seemed like he was giving me low rations as it only had to be raised “a bit”. Which doesn’t make much sense to me still.

#5

I’m 29 years old and have had low test levels for about 8 years now. I did androgel treatment back in years 1 and 2 but it didn’t seem to be working and the doctor was not helpful to what i told him. Now today I have been on androgel again for 3 months. 1st levels were estradiol 7.0 range 10-42, total test 381, shbg 11, and free test 106 range 41-244.

Second blood results estradiol not tested and should have been doc says no need, total test 376, shbg 14, free test 98. Now since my total test, free test went down and the shbg went up after 3wks of androgel 5g per day and I have loss of libido, fatigued, and when I do get off I now have no load to blow not cool what is happening to all the testosterone that I should be getting. Is it aromatizing?

The doctor just wants to up the dose of androgel and test for lh hormones, but I dont think thats the problem. Should I be taking a different med or something else along with the androgel? I have asked for arimidex but again the doc says its not needed. Maybe I should go somewhere else.

#6

You do need better medical care. Your HPTA will be shutdown and testing LH. E2=7 is very low and could be a lab error. Most labs are not able to report that low. You can test E2 by yourself - LEF.org

There is always some aromatization with injections or transdermals. T-gels are the worst in that regard. Higher strength creams applied to smaller area are better.

You need twice that amount of T-gel, you need E2 labwork, you need hCG to avoid loss of fertility. Using Arimidex/anastrozole to lower E2 to near E2=22pg/ml would be optimal.

#7

Would I benifit more from a urologist or an endocrine doc.

#8

Both suck. The best are GP’s who have decided to take an interest in these things.

Best to get a referral from a compounding pharmacist who knows the docs in your region.