Androgel is Useless

Training Over 35 Lifter
21

[quote]olderguy wrote:
Thanks for the link. I found an MD in the Swales MD finder. I have an appointment for next friday. And in my discussion with his secretary, she claims he is down to earth and the patients like him. I just hope I do. At 55, I shouldn’t have a problem convincing them it’s not about getting big, but beings I lift, they automatically think otherwise.

Even if the appointment goes south, I printed out a list of about 50 MDs from NJ that are enrolled in the anti-aging group.

Thanks again.[/quote]

Glad to help. It’s really going to be all about the numbers. If you end up having a problem with your numbers, PM me and I’ll give you some strategies.

22

I’ve found an anti aging specialist trained by A4M that I’m considering seeing. Any advice on what I can expect during the first visit?

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[quote]leonidas4 wrote:
I’ve found an anti aging specialist trained by A4M that I’m considering seeing. Any advice on what I can expect during the first visit?[/quote]

Probably a lot of questioning. If you write down your heath and sexual issues, with a time line. That will help. He will then probably go through what you read and will then not miss anything that concerns you that might be otherwise missed. He can mark up the list instead of also doing note-taking at that time.

List what supplements you are taking. Why you started certain ones. List medications.

Notes on diet.

Energy, apathy, mood, initiative and how these things have changed.

Libido, changes, nocturnal and morning erections. Sexual fantasies / day dreaming. Changes in the size of your testicles and how they hang. Changes in the sensitivity of your penis. Changes in orgasms. ED, lack of hardness, hardness does not last.

Changes in weight and fat. Note that some will loose muscle mass and gain fat with no overall weight changes.

Describe any prostate discomfort, reduced urine flow, frequency of need to urinate, changes over time and changes day to day which can be from drugs or some foods. You should have a DRE before TRT, unless you can report a recent DRE from another doctor.

Cholesterol problems and time line and any similarity with the time line of muscle mass loss and sexual issues.

Describe and accidents and dates when you had a blow to the head or whiplash. Any physical damage to the testicles.

List any drugs ever used as these can affect hormones and libido. List any history of drugs used to lower DHT for hair loss or prostate issues.

Describe moodiness or intolerance [loosing ones temper] with time line. Little things make you angry because they overwhelm you? Talk to your wife/GF for observations.

Feel your chest for breast tissue. Any granularity under the skin? If any, E2 levels are an issue. The E2 levels do not need to be ab-normal, only elevated in range. I think that sub-clinical tissue problems are probably quite common.

Changes in fat distribution patterns.

Changes to skin, thickness and elasticity: Press finger on the back of your hand and drag the skin to the side. Observe crinkle lines. That is a mark of lost elasticity. Pinch the skin and pull up, release and not recovery time. Can be a few seconds to recover. T alone can reverse those indications. Those indications can be considered signs of low T. Make notes and show your doctor if there is a problem. Later when you show him the improvements, he will be please to see that progress.

Discuss your views about injecting and preferences of injections VS transdermals.

Seek T+AI+hCG in writing. Supply the research that supports 250iu hCG SC EOD. If you have a concern for sensitivity, as for compounded 5% T cream at .25ml/day.

Typical start:

100mg test cyp per week
1mg Arimidex/anastrozole per week
250iu hCG SC EOD

All of this is of value for some doctors.

24

is this thread open still?, I have a few comments questions

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All threads are open.

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Hello KSMAN I found you…I was just asking if you was around…You did not reply to my last ? so was wondering if all was well…glad to see that it is

27

what is it with these docs who just ask “can you get an erection” and then dismiss all the symptoms your talking about as meaningless? Sounds like my current endo who is being replaced–hopefully by a new one.

Great and very helpful thread

28

45year old male, hypothytoid since age 13, gynecomastia[puffy nipples] since age 13 yrs. 6’7’’ 290. lift weights and use elipitical machine with little results. High BF with fat around thr middle.
Put on AD meds 3 yrs ago for a bad depression spell. Still on AD meds.
6 months ago decided to check my hormones after reading possible link of hormones to gynecomastia and depression. Hired a company from the web called bodylogicmd.com.
here is me
http://im1.shutterfly.com/procserv/47b7cf11b3127ccec2e9033a2ffa00000016100FcOGbls4Yg9vPhQ

first blood results from 12/07' prior to any hrt

cortisol morning 17.6 high range 3.7-9.5 ng/ml
cortisol noon 6.0 high range 1.2-3.0
cortisol eve 2.3 high range .6-1.9
DHEAS saliva 13.2 ok range 2-23
free T4 1.5 ok range .7-2.5
freeT3 2.4 low range 2.5-6.5
TSH 2,0 OK
ESRODIOL 81 HIGH RANGE 12-56 Pg/ML
testosterone 357 low range 400-1200
SHBG 36
RATIO T/SHDG .3 LOW range .7-1.0
psa 1.7 ok
lh 6.1 ok

started me on meds below 1/ 21/o8
T3 tablets 30 mcg daily Cytomil
Arimidex 1mg tab 2x a week
testosterone cream [ compounded] 20 mgs/ml strength, apply 1 ml dail 6x week
DR WILSons adrenal suppliments, and fish oil tabs

  doing ok till about  5 weeks into HRT,  I had  a bad reaction  in the middle of the night,  itchy,   sweaty, burning skin, SEVERE SUICIDAL depression  return,  hot flashes,  stopped all of the HRT,  took about 6 days and I started to feel better. In the mean time  went to  my primary doc, told him about  my HRT  treatment  from another doc, he  did blood tests. 

     blood results 3/19/ 08,  5  or so weeks into HRT,  then 6 days off
   FREE T 474   RANGE 241- 827 NG./ML
 T4 1.30     .61-1.76

TSH .359 .350-5.50
CORTISOL 17.9 3’1-22.4
FREE TESTOSTERONE 12.4 RANGE 6.8-21.5 PG/ML

stayed off HRT, hired a new Endo doc, he said stay off HRT 4 weeks and retested blood work
4 weeks off any HRT, results
TestosteronE SERUM 305 NG/ML RANGE 350-1030
Free T 1.6 ‘’ 1.5-3.2
free t 49 ng/ml range 52-280
shbg 43 range 20-60
prolactin 7.8 ok
ESTRODIOL .61 RANGE .8-3.5

** note how my estrodiol was low, i was very hiGH estrodiol prior to HRT
2 weeks ago my new endo doc started my on 5 mcg of T3 Cytomil, but dropped my synthroid med from 225 to 200 mcg said the t3 is potent so need to lower the synthoid as we add T3.
I got a B12 shot on my own 2 weeks ago
Started androgel 4 pumps a day 5 days ago.
Now feeling great , no depression at all. Plan on getting blood tested in another week or so, MY FEAR is my natural testosterone will stop, my T levels will drop and I will feel like SH…t
My goal is to taper off the AD meds, get gynecomastia operation for VERY puffy nipples, get hormones under control, loose fat and get a better build. thanks for looking Matt

29

made a mistake, ignore

30

Stay on TRT, T was not the problem. Your E was too low from too much Arimidex.

Your R2 units seem strange. Exactly how is that described? Units also different from the [expected] units in the earlier test.

Without more data, E2=1.4 [3.5 x .4] might be a good target. Some are Arimidex/anastrozole over responders.

Typical dose for a 160 pound lean guy on 100mg test ester per week would be 1mg/week. More would be indicated for your body weight. But you T absorption might have been low. Dose of Arimidex needs to be adjusted for TT levels. With less T in serum, you need less Arimidex.

Try .6mg/wk and if that seems ok after two weeks, go to 1.0 for two weeks, etc… if you feel a loss in regained libido or negative mental effects, resume prior dose and hold for two weeks and test E2 levels. Do not change labs or test types.

Transdermals are a crap shoot, you do not know how much you will absorb or if absorption will go down. Hypothyroidics are famous for poor transdermal absorption. Injection are great as there is not question about how much gets into your body.

For serum E2. Labcorp range is [0-53]. With that range, E2 in the lower 20’s is optimal, approaching 20.

The brain needs a lot of E2 and has a lot of aromatase to make T–E. An aromatase inhibitor can reduce serum E2 as well as E2 created in the brain. The brain does not work right with low E2. That is what happened.

If you are on SSRIs, try switching to generic Wellbutrin. Start with 100mg/day, then work towards 200, 300, 400 and find what feels right for you. You doc should let you have that freedom. This will increase your dopamine, improving mood and energy, with no negative sexual sides. Trazodone for sleep is very cheap, 4.00/month. It is also good for dopamine levels.

What cholesterol numbers and are you taking statin drugs?

hCG injections will save your testes and avoid sterility .

T+hCG+AI

31

[quote]KSman wrote:
Stay on TRT, T was not the problem. Your E was too low from too much Arimidex.

Your R2 units seem strange. Exactly how is that described? Units also different from the [expected] units in the earlier test.

Without more data, E2=1.4 [3.5 x .4] might be a good target. Some are Arimidex/anastrozole over responders.

Typical dose for a 160 pound lean guy on 100mg test ester per week would be 1mg/week. More would be indicated for your body weight. But you T absorption might have been low. Dose of Arimidex needs to be adjusted for TT levels. With less T in serum, you need less Arimidex.
[/quote]
**** WHAT DO THE ABOVE MEAN? I AM ON ESTROGEL , WHAT IS 100MG TEST ESTER MEAN?***

*** WHAT ABOUT DIM TO CONTROL E2?, MY DOC MAY NOT GIVE ME ARIMIDEX***

[quote]
Transdermals are a crap shoot, you do not know how much you will absorb or if absorption will go down. Hypothyroidics are famous for poor transdermal absorption. Injection are great as there is not question about how much gets into your body.[/quote]

*** EVERYONE IS TELLING ME TO GO WITH SHOTS, I WANT TO GIVE THE GEL A CHANCE FIRST’’

[quote]
For serum E2. Labcorp range is [0-53]. With that range, E2 in the lower 20’s is optimal, approaching 20.[/quote]

** PRIOR TO ANY TRT OR HRT IS WAS AT 81 E2, IT DROPPED TO LOW WITH THE ARIMIDEX LIKE YOU SAID***

CHOLESTEROL GOOD, NO TO THE STATIN DRUGS*

[quote]
hCG injections will save your testes and avoid sterility .[/quote]
HCG, WHAT IS THAT?, I thought I wanted T-CYP SHOTS

[quote]
T+hCG+AI[/quote]

     ***I AM GOING TO HAVE A HARD TIME FINDING A  DOCTOR TO  CO -OPERATE  WHTTH THE PROTOCAL   YOU OUTLINED**

APRECIATE YOU INPUT, IF YOU HAVE ANY FOUNDATION, WATERPROOF, CONCRETE OR MASONRY OR STRUCTURAL ISSUE ASK ME
WWW.MTAYLORENTERPRISE.COM

32

MY answers and question s are in the grey area of your post in the astericks

33

Testosterone esters: such as cypionate or ethanate.

DIM and such are often not going to get the job done, otherwise we would be using those things. You can try.

There are many reasons why transdermals are not right for many guys. Transdermals are way more costly as 90% of the T is lost at best.

Google [hCG wiki] and read. Also Google [hpta wiki. Do a few weeks of research; most of use have to get that done. Typically, you will end up knowing way more than most doctors.

You need hCG with T, as TRT will shut down your testes and you are then going to be sterile in the long term with tiny testicles with your scrotum pulled up like a little boy’s.

Do you do concrete in Kansas :wink: ?

34

KSMan, you could make a fortune if you wrote a book.

35

ksman

E Follows T

Here’s where doctors fuck up. They forget that E follows T. As your T levels go up, so will your E levels. If you’re not doing something to control your E (like taking an AI) then you aren’t really going to get anywhere with higher T levels because your higher E levels are just going to cancel out any beneficial effect from the T. Like I said, your T can’t do you any good if all your androgen receptors are bound with estradiol.

Saw this on another thread, now I understand

BTW I started on androgel 1 week ago, going in for testing on the 17th this month . Do you see anything I should add to the following tests [ I am hypothyroid too, started on low dose of T3 last month in addition to synthroid]
free and totoal T
shbg
prolactin
serum E2 estrodiol
lh
t4 free
tsh
freet4
free t3
cortisol

I HAD E2 levels of 81 in the past [ 10 to 50 scale] , I think I should consder ADEX in the future.
Also the hcg you mentioned

36

Keep in mind that guys who have low thyroid levels are poor at absorbing transdermals.

If your T levels do not go up, LH may not decline. If T levels go up, LH will be near zero. Almost pointless to test once TRT starts, but is good for a pre TRT diagnotic.

You need a pre TRT PSA baseline to compare with post TRT PSA numbers. You also need a before and after DRE. If transdermals are not working well, PSA numbers will be of limited value.

Transdermals can push DHT too high and that should be tested. I would wait until your dose or delivery is final and settled in. DHT levels when your T is not high enough is not very useful.

TRT, with E controlled, will affect every cell in your body. Tyroid state will probably change, presenting a moving target.

Your cholesterol should go down if elevated now. Good to have before and after numbers.

Never had a blood work for PSA after ejaculation or a DRE, as this will increase PSA to an non representative number and may also indicate a non existent prostate problem.

37

KSman

I do have a pre TRT baseline test results.

Do i want my LH number in the mid range? why should I even test LH?, as far a DHT, i do not see that test on any of my blood reports, could that be under another test name ?

I like the androgel cream, I want to use it for a year to see if I can get my T numbers up to 700 or so.

Coorect me if I am wrong, but shouldnt my two biggest concerns now be is keeping me E controlled, and getting me T up when my testis stop working do to the gel?

Is it likely my Testis will shut down do to the gel, thus I will be at a net loss of T once testis shut down?

At what point do I ix in the HCG you mentioned?

38

had a pituitary mri today, looking for any lesions that may contribute to hormone issues

39

[quote]matthewt wrote:
KSman

I do have a pre TRT baseline test results.

Do i want my LH number in the mid range? why should I even test LH?, as far a DHT, i do not see that test on any of my blood reports, could that be under another test name ?

I like the androgel cream, I want to use it for a year to see if I can get my T numbers up to 700 or so.

Coorect me if I am wrong, but shouldnt my two biggest concerns now be is keeping me E controlled, and getting me T up when my testis stop working do to the gel?

Is it likely my Testis will shut down do to the gel, thus I will be at a net loss of T once testis shut down?

At what point do I ix in the HCG you mentioned?

[/quote]

LH testing is for diagnostic purposes. Once on TRT, it will be turned off if the TRT is effective. Then further testing is useless.

Transdermal T causes higher DHT than from injections. You should check this once you get your T up to a therapeutic level. Transdermals also create more E. Test for E every time you check TT, FT levels.

T levels do not increase over time, for more T, you need to take more Androgel.

Control E2 to be in the lower 20’s [0-53 pg/ml]

Gel increases T, that and increased E causes the HPTA to reduce or stop LH. Testes shutdown and your only source of T is from your androgel. There is no net loss. You need hCG to maintain your testes.

You need hCG a few weeks after starting [effective] TRT, technically after a few days.

40

KSman
you posted this as a starting point for another guy on this thread

Typical start:

100mg test cyp per week
1mg Arimidex/anastrozole per week
250iu hCG SC EOD

All of this is of value for some doctors.

Well, I am on androgel an plan on giving it a shot, being hypothyroid , I dont know how well it will work. [ T level 351, [400 to 1200 range]

Should I  just come out and ask the  doc  for T cyp shots and  AI  outrite? , my    blood work certainly suggests I need  it. Or  should I stay on the androgel   and  wait till he is  convinced I need a  AI and  T- cyp?

Also, I have another doc in the wings that will give me compounded T cream , higher strength then androgel, but I am staying away from that doc because she made me nervous putting me on so much T3 [ 30 mcg] without lowering my synthroid intake, plus she gave me 1mg tabs of arimidex to take 2x a week and I got hot sweats and tingle over it.

SO,
I have been on T gel 2 weeks felt great, last few days depression returned , I suspect e2 is way up too. E2 was 81 [ 10-50 range].

Testing free T and total T at the 2 week point tommorrow, then at six weeks we will retest for;

progesterone
glucose
nmr lipofile
estrodiol
free T
Total T
thyrogoblin ab
TSH
T4
T3
URIC ACID [ GOUT]

MY COLesterol and PSA are good

how critical is it to monitor LH,DRE,DHT?
Waht is DRE?