T Nation

The Right Decision...?


Hello Everyone;

My doctor just put me on Testopel. Implanted about 3 weeks ago. Not crazy about the process as it is somewhat painful for at least a week, and I am fairly active which seems to have led to one or two pellets popping out of the incision. Took approx. 12 days to heal. I've had many of the symptoms described here for low T and testing confirmed that. Not sure if I should switch methods or try something different.

My case:

38 yr old
34" waist
200 lbs
Average body and facial hair
Approx. 12% bf fairly evenly distributed
No health issues, prior symptoms: low energy, slow workout recovery,
No Rx currently, have done AAS in the past (4 or 5 cycles mixed Test, Deca)

Have 2 lab reports, but don't have a copy of the 2nd yet (was not fasting prior to the test listed)

FSH 1.2 1.6-8.0
LH 0.9 1.5-9.3
Heavy metals panel 5 <23
Lead <2 <10
Mercury <4 <10
Cholesterol 142 125-200
Triglycerides 74 <150
Glucose 108 65-99
BUN 15 7-25
Creatinine 1.07 .79-1.33
Sodium 151 135-146
Potassium 4.9 3.5-5.3
Chloride 111 98-110
Carbon Dioxide 20 21-33
Calcium 10 8.6-10.2
Protein total 6.9 6.2-8.3
Albumin 4.8 3.6-5.1
Globulin 2.1 2.1-3.7
Bilirubin .5 .2-1.2
Alkaline phosphatase 45 40-115
AST 29 10-40
ALT 47 9-60
Phosphate 3.6 2.5-4.5
Uric Acid 5.1 4.0-8.0
LD 157 100-220
GGT 17 3-90
TSH 3rd Gen .89 .40-4.50
T4 6.1 4.5-12.0
T3 81 76-181
Testosterone Total 233 250-1100
Testosterone free 53.2 46-224
Testosterone bioavailable 107.2 110-575
SHBG 14 8-48
Albumin, serum 4.4 3.6-5.1
White cell count 5.8 3.8-10.8
Red cell count 4.84 4.20-5.80
Hemoglobin 15.2 13.2-17.1
Hematocrit 45.4 38.5-50
MCV 93.9 80-100
MCH 31.5 27-33
MCHC 33.5 32-36
RDW 13.5 11-15
Platelet count 196 140-400
MPV 10.9 7.5-11.5

Average, clean diet leaning toward high protein, plus multivitamins, creatine, fish oil
Heavy weight training throughout my 20's now sports specific
-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections changed - Less common in the last 3 yrs or so


Since you are active, creams or patches probably wouldn't be a good idea as well since they rub off with sweat and because they are overall messy in general. The majority of people have more success with testosterone injections. It's also the cheapest method as well.

Your FSH, LH levels are really low suggesting secondary hypogonadism. Your TSH looks great but you're on the low end of T4 and T3.


An odd profile:
TSH 3rd Gen .89 .40-4.50
T4 6.1 4.5-12.0
T3 81 76-181

Looks hypo.

You really need TSH, fT4, fT3

Check your waking body temps, record and report. Check when you wake. If below 97.8m, check during the day to see if you get to 98.6

Using iodized salt? [sea salt does not count unless iodine is added]
Iodine in vitamins?



Ok, waking temp today is 98.0, will start recording every day. I don't use much salt at all, and no iodine in the supplements that i see.

Doctor seems to prefer cream/patch/pellets, but injectable is fine w/ me especially if its less expensive.

I will get my 2nd lab report in a few days to make some comparisons, this was a different lab but the doc said total test was at 140.


Safe to assume that you are iodine deficient. Find supplements that have iodine, typically 150mcg with is RDA. Get an other iodine rich supplement and go through a bottle of that to build iodine stores

Waking @98 is good.


Alkaline phosphotase is low this is a huge red flag for low adrenal, low thyroid, low testosterone, and maninly zinc deficeincy.

I think you Dr is barking up the wrong tree, but like Ksman said more data is needed.


Update; blood work from the day prior to Testopel

Hemoglobin A1C 4.9 3-6
FSH 2.58 0.7-11.1
LH 5.00 0.8-7.6
Prolactin 6.43 2.6-24.5
TSH 1.49 0.40-4.00
Free T4 1.39 0.8-1.9
Estradiol <20.0 0.1-56.3
DHEA Sulfate 234 80.0-560.0
Total Testosterone 140 212-755
SHBG 11.8 7.2-100.0
Free Androgen Index 41.1 19.2-123.2
C-Reactive Protein <.300 <3

Just did new blood work to see how the pellets are working. Feel normal after the initial issues. Doctor wants to do one more round of pellets if the lab report looks good, possibly switching to the side hip insertion point. If that is a problem again I will request regular injectable. Docs just seem to like the bioidentical pellets.

Waking temps have been averaging around 98.0 but I am using an ear digital therm. Not sure how accurate they are.


Doctors make a lot of money with pellets. So how un-biased can a doctor be?

The wrong E2 lab was done. You are not a woman. You need a 'sensitive' test to resolve male levels.

Get going on the iodine!

List supplements and describe diet.


Yeah, I was thinking that about the pellets too.

Which is the E2 number? edit: looked it up in the sticky

Now taking the GNC Mega Men Performance & vitality version which have 150mcg iodine (as potassium iodide)

Typical day: Breakfast Turkey/eggwhite/tomato on a bagel w/ coffee. Banana or yogurt w/ oatmeal mid AM. Lunch Green salad w/ beans/chicken various veg sides. Protein shake or bar late afternoon. Dinner Red meat, fish or chicken w/ usually sweet potato + veg sides. Usually drink straight water. Upped my water intake on doctor recommendation. He also says to reduce carbs and up the fats. I don't consume a great deal of carbs as is, but I will eat a sandwich lunch a couple times a week and not a big fan of the ultra low carb diets. I do a couple of tbsp of fish oil along with the capsule in the Mega Men packs for fats as well.

I was travelling the last couple of weeks and got a stomach bug at some point, so I was obviously not feeling great. Now that things are back to normal I feel good, although I would not say 500mg of test per week good... But I would not say I felt terrible prior to TRT either, there were certainly symptoms but I would never have guessed that my T was so low. Very curious what the lab report looks like now.

Lucky I happened to have a doctor who recognizes this, and this forum with so much info. KSman thanks for your input it really is greatly appreciated. Hopefully I'm at least on the right track now.


Got a call from the doctors office today about test results after 1 month Testopel (12 pellets).

They said I am at 347 Total. Still seems very low. Is it possible that the pellets are being rejected or otherwise not working properly? Still too early?