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Testosterone and E2 After 4 Months of Gel Use


#1

Hi and thank you for having this forum. Invaluable.

Age 45
Height 6 ft.
Waist 36
Weight 230ish
Body composition: slightly muscular, thick, heavy. Thick goatee. Never been this heavy in all my life.
Carry fat in gut, love handles
Health history: Never saw/needed doc until Lyme disease 5 years ago. Took doxy and recovered fine.

About 3 years ago began gaining weight while lifestyle remained same. Mind fog became worse than basic -where did I put my keys?- Although I have always had a kind of fog going on.
Libido and erection duration began to get worse -never was superman like-

Recently could not take it anymore and started eating better and working out in gym made in basement, thinking I could correct this by not taking drugs but by doing the best I could in diet and exercise.

Got tested for low T and was diagnosed hypogonadism by doctor. See below for Tgel history. GP great woman and wants to help and listens to me but is not versed in T et. al so only got so far before endo was referred. Appointment in one month.
RX: Cialis and recently Tgel. Got liquid Anastrozole coming 12/16 and will see if E2 comes down.

Labs results: see below posts

Diet: High in protein from turkey & chicken as well as egg and whey protein shakes. Fruits like apples and bananas. Minimal vegetables unfortunately. Peanuts. No soda/energy drinks. Coffee. No traditional white sugar. Some Stevia. Glass of red wine 3-4 times a week.

Supplements/vitamins: Most of these are recent additions, about when I decided to change myself for the better. I may have gone overboard. All are 1Xday unless noted otherwise.

Glucosatrin
L-arginine (free form) 1000mg 2Xday by NOW foods
L-Citrulline (free form) 2000mg 2Xday by NOW foods
Vit D3 1000iu by Nature’s Bounty
Magnesium 500mg by Nature’s Bounty
Grape Seed 250mg by NOW foods
Icarin 50% 300 mg by Swanson Superior Herbs
Hawthorn 80mg
Fish Oil 1000EPA/500DHA by NOW foods
Multi-vitamin called Adam by NOW foods
Beet Juice Powder (taste like crap) by Activz 1 scoop
BCAA 3 pills 1Xday
Isotonics OPC-3
Isotonix resveratrol
Whey protein Shake
Egg Protein shake by Healthy-n-Fit

Training: 4 Days/wk weight lifting–progressive overload technique. Lifting for over 2 months now as of Dec 15. Have made substantial gains in lbs. lifted and slight increase in musculature, lost ~10 lbs. but none on my gut or sides really. Very difficult lifting because I have no energy/will but have not stopped doing it. Tired of this shitty life but cannott give up or all will seem lost.

Testes never ache. Never had a fever.

No morning wood.

Here begins my current bout with T. Sorry about long post.
All blood drawn by Quest Labs (although I think they send some out to other places to get results). All Gel applied as prescribed.

8/7/2015 Got Tested Asked doc to check for low T after many years of low libido, always foggy head, lost interest in hobbies and the list goes on. I knew not the slightest thing about Low T before reading about it somewhere when I was looking into supplements after I started lifting recently (around 240 ~17% BF) So I just asked my GP for total T. Total T was 283

08/13/2015 50mg generic Testim for a 2-week trial.

08/27/2015 Got Tested. Applied in morning few hours before Quest lab test (Not sure if this was a good idea)
Total T 638 ng/dL Range 250-1100 I kept going with that same 50mg/day dosage for the next month. Feeling better but not like I am a new man. Reduced fogginess, more energy, more frequent libido improvements

9/30/2015 Previous benefits appear to be gone. Crap. Ho Hum textbook gel response. Body reduced production perhaps. But still curiously going up with my weights in lifting. Tell Doc and we proceed.

10/05/2015 Got Tested. Still on 50mg generic testim (made by Prasco) This time no application before test. Applied previous morning. Total and Free T plummet. Estrogen starting to rise.
Total T 80 ng/dL Range 250-1100
Free Testosterone 18.6 pg/mL Range 35.0-155.0
Estrogen, Total, Serum 132.3 pg/mL Range 60-190

10/10/2015 Since I am clearly a buffoon and have not researched much at this point, I ask for an increase in Gel which my GP grants as my T is back down. So I double it to 100mg/day for 8 weeks as recommended by Doc and that we should test again then.

12/10/2015 Got Tested. Applied only 50mg in morning few hours before detailed Quest lab test fearing a spike #. Had been using 100mg generic Androgel (made by Perrigo which is labeled by the pharmacy on the box as generic Testim, which it is not) I swear this whole T thing is not well known by many people that otherwise should know. Pharmacies are even mislabeling, which could possibly be significant as not all Gels are absorbed equally. But what do I know. I know that doubling the dosage for 2 months I ended up losing my $$ and gaining T slightly, E and Hematocrit/Hemoglobin. But also feeling like nothing special has just transpired physically or mentally.
Total T 662 ng/dL Range 250-1100
Free Testosterone 161.1 pg/mL Range 46.0-224.0 pg/ml
Bioavailable Testosterone 331.3 Range 110.0-575.0 ng/dL
Estradiol, 49 pg/mL Range < OR = 39 pg/mL

There was a lot of stuff tested but here is what was out of range:
FSH <0.7 Range 1.6-8.0 miU/mL
LH <0.2 Range 1.5-9.3 miU/mL
T3 Uptake 41 Range 22-35 %
Hemoglobin 17.5 Range 13.2-17.1 g/dL
Hematocrit 52.4 Range 38.5-50.0 %
Estradiol 49 Range < OR = 39 pg/mL

GP lacking proper knowledge so got an appointment with and endo nearby. Kinda thinking if I had just ordered some E reducer (online research grade stuff) and gave blood which I am doing in 3 days I might be good. Not looking forward to new doc after my experiences so far. This all seems so simple until something goes wrong.
Could that E # cause this lack of decent T level response. I know high E can but is it likely this like high enough out of the range to squash my available T?
If you have a few seconds lend me any of your comments/suggestions.
Thanks so much.


#2

Please read these stickies:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Please post all of your thyroid labs [TSH, t3, T4, fT3, fT4]

T3 Uptake 41 Range 22-35 %

You appear to have low thyroid hormone levels.
Do you feel cold easily?
Not using iodized salt or vitamins that list iodine+selenium long term?
Outer eyebrows sparse?

Poor transdermal absorption rates are associated with low thyroid function.

Most doctors are clueless about male hormone health. Endo’s and urologists seem to often be the worst. See the finding a TRT doc sticky. Testing LH/FSH while on TRT is a measure of stupidity, these should go to zero.

The most cost effective and controlled TRT is self injected T which has the lowest potential for elevated E2.

Donate blood if you can.
Avoid iron fortified foods and vitamins for males should not have any iron.


#3

Thanks KSman.
I will read all that over the next few days. I should have before I posted I know, my bad.
Here are the test I have had done a few days ago. I will get the rest asap.

So SHBG is important because it carries testosterone through the body, making it available to cells and tissues. Without it, there will be a decrease in the amount of usable testosterone.
If I do indeed have Hypothyroidism, it seems easily treated and then my testosterone should be available for my body to use. Probably not that simple but one can hope.

I do not have any of the symptoms/characteristics you posted but Low T and Low Thyroid have many of the same, and there are a few I do have clearly.


#4

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#5

Your estrogen is quite high. If mine gets much over 30 pg/ml I feel awful.


#6

"So SHBG is important because it carries testosterone through the body, making it available to cells and tissues. Without it, there will be a decrease in the amount of usable testosterone. "

That is WRONG. Applies to estrogens but T+SHBG is not bio-available! Many have this confused.

If otherwise, TT and bioavailable T would be the same.

Your thyroid problem is very serious.
Check your overall thyroid status by checking oral body temperatures:

  • when you first wake up, should be 97.7-97.8, higher is OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon

"it seems easily treated"
You want to avoid having a doc put you on a lifetime of thyroid Rx medications if the root problem is iodine deficiency.
That is why I asked about your use of iodized salt or vitamins that list iodine+selenium.
Selenium is very important to avoid thyroid autoimmune disease and very critical when doing iodine replenishment [IR].

You need to read the thyroid basics sticky.


#7

Davinci.V2–Yes those E2 levels are high and I do feel like crap. Thank you though for the reference. I knew it was high but not “how high”. I realize we all react differently but It’s good to note it is high enough to possibly be contributing to my ill feelings.

KSman I did read some of the thyroid basics last night but I got confused. I will keep reading it over and over until I understand it.

I did remove regular table salt from my diet quite some time ago. I eat a fair amount of salty snacks though but not sure if this is iodized salt or not.
My multi-vitamin I have been taking for ~1.5 months has has 75mc iodine as well as 100mc selenium. Before that no vitamins to speak of.

I am posting the complete test results so far since the beginning of this whole affair to help me keep things straight. There was a pending result for my dihydrotestosterone which is now included. This number is high as you can see.
Anyway, thanks again and I will take my temp in the morning and then the afternoon. I will also get the rest of the lab numbers you spoke of.


#8

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#9

Please check body temperatures now.

Thyroid labs mislead doctor.
TSH should be closer to 1.0, do not see test data
T3, T4, fT3, fT4 should be mid-range or slightly higher.

T4 is very low, suggesting iodine deficiency
T3 uptake is too high, indicating low T3
Better to test TSH, fT3, fT4

Do you feel cold easily?
Outer eyebrows sparse?

please try to address all points in my posts so I am not back tracking.


#10

I have taken my morning and afternoon temps for the past 2 days
I took each one 3 times in succession;
1st morning 97.1, 97.3, 97.7
1st afternoon 98.2, 98.3, 98.4
2nd morning 97.7, 97.6, 97.7
2nd afternoon 98.2, 98.3, 98.5
I am not completely trusting my new thermometer as it rarely shows the same temp. I think I would rather get another one and run them side by side 3 times each and see what happens.

Could have got all desired thyroid labs you spoke of–yesterday but I asked to include sensitive E2 test because when I looked it up somewhere on this site–a quote from crislers book stating that it should have been the sensitive one and it was not.

Of course now my Quest only has the ultra-sensitive LCMSMS assay available. But I am trying to get it anyway along with the regular --if my doc agrees which I think she will as it is no skin off her back–.

I just started taking liquid Anastrozole 2 days ago at 3 drops per day and am getting my brain back slowly as well as energy. Damn I was foggy. I have since noticed a difference. I am curious if my E2 numbers have gone down. However, this is very preliminary.

I had to stop the gel for around 4 days because all it was doing was making my whole system feel clogged and slowed down. Took it this morning and felt pretty good.
I am getting tested tomorrow for the thyroid parts we discussed–irregardless of whether or not the E2 is ok’d–. My GP said --T3 LEVEL VARIES, BUT IS NOT DIAGNOSTIC OF THYROID HYPO-FUNCTION.

Just got lodoral 12.5 mg tabs today. I took 2.
I will get another thermometer tomorrow and check temps again. I will compare my numbers every day to see if they go up any.

I do not feel cold easily.
Outer eyebrows a little sparse. More sparse then the insides.

Just so we are on the same page–I am getting TSH, T3, T4, fT3, fT4 done tomorrow. I know I have some of these already but I want another whole set.


#11

Forgot–I also gave blood on Tuesday 12-15-2015. Blood hemo was 17.9 according to machine at blood center.
–1 pint–


#12

Got drawn for TSH today. Found out my GP doesn’t think the rest is necessary including sensitive E2 assay. I don’t understand why she doesn’t just do what I ask if it is no skin off her back but a simple phone call. Ticks me off that even if I go into quest with a fistful of 1000 dollar bills they will not take my blood unless I have doctors orders. BS.

Furthermore she thinks I should wait to see what endo requires as far as further testing [but that appointment is not until 27th of Jan]. Got a lead on a urologist from a guy at Quest that supposedly is progressive and knowledgeable so made an appointment.

Getting my hands on a presumably very accurate/reliable thermometer tomorrow. Same one that doctors and hospitals use. That piece of crap thing I got from the pharmacy keeps giving me inconsistent readings by a large margin, and it was their top of the line lol.


#13

[quote]Sertoli wrote:
Got drawn for TSH today. Found out my GP doesn’t think the rest is necessary including sensitive E2 assay. I don’t understand why she doesn’t just do what I ask if it is no skin off her back but a simple phone call. Ticks me off that even if I go into quest with a fistful of 1000 dollar bills they will not take my blood unless I have doctors orders. BS.

Furthermore she thinks I should wait to see what endo requires as far as further testing [but that appointment is not until 27th of Jan]. Got a lead on a urologist from a guy at Quest that supposedly is progressive and knowledgeable so made an appointment.

Getting my hands on a presumably very accurate/reliable thermometer tomorrow. Same one that doctors and hospitals use. That piece of crap thing I got from the pharmacy keeps giving me inconsistent readings by a large margin, and it was their top of the line lol.[/quote]

If your Dr isn’t willing to work with you, that’s when you professionally remind her that you’re paying for said services, have concerns of your own and if she’s not willing to work with you and help sooth some of your concerns, you’ll unfortunately have to look for another GP.


#14

Doc also has a master called insurance company.


#15

Tried out my new thermometer this morning–Welch-Allyn brand–.
1st run 98.4, 98.6, 98.4
2nd run 98.6, 98.4, 98.4

Vicks thermometer from Wallgreens
1st run 97.4, 97.8, 97.6
2nd run 97.9, 97.7, 97.6

I will try them both out again this mid-afternoon.


#16

[quote]KSman wrote:
Doc also has a master called insurance company.[/quote]

Still, if you take away the patient you take away payment from said insurance company. Worst case scenario if the insurance company will not pay, the Dr’s office should simply charge the OP and it sounds like the OP has money to pay out of pocket for the labs that the insurance company wouldn’t cover.


#17

More thermometer readings from this mid afternoon. This is the same day as the morning post. --Welch-Allyn brand–.
1st run 99.4, 99.3, 99.3
2nd run 99.3, 99.3, 99.4
Total average 99.33333…

Vicks thermometer from Wallgreens
1st run 98.5, 98.7, 99.1
2nd run 98.7, 99.1, 98.7
Total average 98.80

So the totals so far:
12/16 Vicks thermometer from Wallgreens
97.36 average morning temp 3 readings
98.30 average afternoon temp 3 readings

12/17 took 12.5mg X2 lodoral AM [no side effects]
Vicks thermometer from Wallgreens
97.66 average morning temp 3 readings
98.33 average afternoon temp 3 readings

12/18 12.5mg X2 lodoral AM [no side effects]
12/19 12.5mg X2 lodoral AM [no side effects]

12/20 Welch-Allyn thermometer
98.46 average morning temp 6 readings
99.33 average afternoon temp 6 readings

Vicks thermometer from Wallgreens
97.66 average morning temp 6 readings
98.80 average afternoon temp 6 readings

I guess I should stick with one thermometer. Even if it is wrong I can still see if it goes up from the lodoral. The vicks actually seemed fairly consistent now that I look at it closer. I definitely felt warmer than usual though so I suspect the true temp is represented by the Welch-Allyn thermometer.

So does this indicate anything regarding my thyroid function?

Note of interest:
I decided to lather the gel on after none for 5 days. I was feeling great after the anastrozole began working. Friday applied gel–great mood, energy etc.

Sat. applied gel–same ole bogged down feeling like I am dragging an anchor and hum bugging everything. I was taking the anastrozole then as well but I guess it is either too early to take the gel or it just isn’t enough of a dose while on the gel.

Today, Sunday-applied no gel and took no anastrozole and felt great. What a impressive mystery our systems can be.

Re: insurance and doctors
I pay all year long towards my insurance, which until this year and a brief bout with Lymes a while back–I have never used it in 15 years.

My insurance would cover most and maybe all test minus a nominal fee. They never pay for it completely, which is ok as they cover the bulk of it.
So it’s all the more annoying when my doctor isn’t paying for any of it, but has the last word. It should be between me and my insurance company. If I have an issue and want to have something tested for, why does she get the power to say no? Do doctors get into trouble if they keep ordering blood test?


#18

Got back my TSH level from Quest:
Could not get fT3, fT4. GP face-palmed me on that.

So this is what I have:
TSH 1.09 mIU/L Range 0.40-4.50
T3 Uptake 41 Range 22-35 % [T3 uptake is too high, indicating low T3-KSman]
T4 4.5 Range 4.5-12 [T4 is very low, suggesting iodine deficiency-KSman]

So my TSH is good.

12/21 Welch-Allyn thermometer
98.66 average morning temp 6 readings
99.66 average afternoon temp 6 readings

My temps seem to be creeping up with the supplemental Iodine even though I dropped it to 12.5mg/day
The noticeable effect has been a slight flush in my face and a hotter general feeling in my body.
I seem to be responding to the IR.

I would rather not have over 100 as my average afternoon temp to become my norm which could be if this trend continues.
I could cut it to 6mg/day.
Anyone want to throw their Iodine hat in the ring here?

Side question while I have you here:
Could a man have above normal Estradiol levels naturally and by taking the right amount of anastrozole raise his T to a level where he is content and living well?

Should I go to 6mg/day? Or none at all?


#19

Your thyroid story is odd.
Can you get numbers from other family members with those thermometers?

Your diligence is amazing.

As you eval iodine, note if metal alertness changes. Oh, that will not work, your T-E2 roller coaster is dominant,

Lyme can change a lot of things.
What is your exercise tolerance like now?

“Could a man have above normal Estradiol levels naturally and by taking the right amount of anastrozole raise his T to a level where he is content and living well?”

Yes, if T was only low because estrogens were elevated and a result would have to be strong.

Give this time and keep taking iodine and selenium.


#20

Re: thyroid story odd
Not much in this world is cut and dry.

Stopped Iodine for 2 days. will do AM temp test tomorrow
12/23 afternoon temps

My temperatures
Vicks thermometer
98.10 average afternoon temp 6 readings

Welch-Allyn thermometer
98.78 average afternoon temp 6 readings
This is almost a degree lower from last reading 2 days ago. What is half life of lodoral?

Wife’s afternoon temperatures
Vicks thermometer
98.55 average from 4 readings (only 4 she was getting annoyed at me go fig:)

Welch-Allyn thermometer
98.90 average from 4 readings