T Levels Going Backwards on TRT

Baseline T level =148 ng/dl

Started TRT with Axiron 1 month ago.

Have been feeling better with more energy, alertness, improved outlook on life, more libido (able to have erections & sex 2x per day if I want to), feeling strong at the gym and muscles feel full and toned. My wife has stated what a difference she’s noted in my energy and mood. I’m not as irritable and moody.

Due to my long arms and legs, I’ve never been an impressive strength lifter. I used to struggle with 185 as a bench weight. In college, my best bench was 245. In one month at the gym and getting back into lifting, I’m repping 185 x 5 or 6 no problem. Did 225 one rep max in Smith Machine. Doing Russian Swings with 32 kg kettlebells x 15 reps x 4 sets. Deadlifting 275 x 5. Doing HIT cardio 15 to 20 mins every other day or every 2 days. Just giving you an idea where I’m at going from no weight lifting for 5 years to 1 month at the gym and on TRT.

Thought all was going great. Had labs yesterday. Applied Axiron on Sunday morning. Labs on Monday morning, prior to any T application.

Got lab result today.
T = 73 Ng/dl
Estradiol = 19.3


Ordered to double the application of Axiron to two wipes per pit per day. Labs again in a month.

Placebo effect of T or lab error or What The F is going on?

I’ve seen T tests vary by close to 50% for no apparent reason (prior to starting any TRT). I’ve also seen labs make out-right mistakes - either equipment was grossly out of calibration or they swapped with someone else’s test. I know nothing about Axiron (using injections personally), but I’d be cautious about reading too much into a single test.

Not that others lend much credibility to this, but I had a similar issue. According to my doc and ZRT labs, transdermals are actually absorbed much closer to 100% versus the 10% assumed by others. The problem is that it isn’t reflected in conventional venous testing. By using the reuslts you have, you will end up dosing upwards until you are at supraphysiological doses and your t-receptors will start to desensitize and you will feel like crap (again a poor summary of what they told me and I encourage you to read more and see if it makes sense). As a reference, below are my results from serum vs blood spot testing while on cream (huge difference and no I did not use my hands or arms to apply for many days prior). I have also included a little snippet from ZRT labs on why blood spot is the way to go when using transdermals, but the full paper is on their site.

Total Testosterone

Venous 543 ng/dl (348-1197)
Cap Blood Spot 7,129 ng/dl (400-1200) Not a typo!!

Using Topical Hormone Supplementation
A fourth and very important reason to use blood spot testing is that, like saliva, hormones present in the capillary blood from the finger are more representative of the hormones being delivered to other tissues of the body. With hormones delivered through the skin (e.g., topical, vaginal, sublingual/troche) as supplements, the capillary blood spot hormone level rises in concert with an increase in salivary hormone levels because this represents hormone delivery to tissues throughout the body. In sharp contrast, blood taken by conventional venipuncture rises very little, not at all, or even decreases in some cases with skin delivery of hormones. This might seem odd, but blood being delivered back to the heart through the veins has already delivered its bioavailable hormone load, and hormones remaining in the bloodstream are tightly bound to serum proteins such as SHBG and albumin. An easy way to conceptualize capillary blood (teaming with bioavailable hormones) versus venus blood (depleted of bioavailable hormones) is to think of the oxygen content of red blood cells in the capillary beds versus the venus blood returning to the heart. Blood being delivered to the tissues through the arteries, arterioles, and finally through the capillary beds of tissues is charged with oxygen that is released into the tissues. Blood traveling back to the heart is depleted of oxygen. In a similar way, hormones delivered through the skin are picked up by red blood cells, and the hormone-laden red blood cells are then transported within seconds throughout the body to capillary beds of all tissues. There the hormones are released. This is why we see high capillary blood levels of hormones in blood spot testing and much less hormone in venipuncture serum.

Thank you, Cirerecrem. That explanation seems sensible.

I was afraid my antiperspirant / deodorant might be absorbing a lot of the testosterone from the Axiron application. I did a lot of reading and the studies I read showed no difference when applied before or after deodorant. However, antiperspirant wasn’t mentioned.

All I know is that I applied Axiron for the 2nd dose starting today and now I have a headache and my head is throbbing. And I feel very shakey & jittery.

So you were feeling awesome on TRT, kicking ass and taking names. Giving your wife all you can handle. seeing gains in the gym you haven’t seen in decades.

But you get depressed of some “score”?

THat does not make a lot of sense to me…we don’t chase numbers, we chase results…and your results were just about perfect.

I agree. I was feeling great before. Now after doubling the dose for 4-5 days this week, I don’t like the way I feel. I am shaky, nervous, have headaches, insomnia. In general, feels like a constant adrenaline dump.

That being said, don’t we do labs to try to establish ourselves into normal or therapeutic ranges? The lab results are confusing me and none of this is making sense. I agree it’s probably more important to feel better than worry about a lab result. However, the two should correlate to some degree and go hand-in-hand. Otherwise, what’s the point in doing any labs? The stickies here center around labs. I would just like to get this therapy straight, feel good, and have some correlation with labs that my body is working at optimal levels.