Low T: Urologist or Endrocrinologist?

Pharma / TRT Testosterone Replacement
1

I was feeling like crap for years. I was put on SSRI’s (antidepressant) for years, but still felt off. Two-three years ago I talked to my GP who did some tests. My Test level was 148 or so. He put me on weekly injections. They were marginally helpful in upping the blood levels (up to 230 or so if I remember right).

I then decided to try a urologist. After going through his hoops I was put on 5g of Androgel daily. After a month, I got blood tests again and my levels actually went down. I didn’t apply the gel prior to the test, though). I was then instructed to try 7.5 grams per day. My levels again went up 20 points. I then got to thinking and asked if I should have applied the gel immediately prior to the test and the nurse said yes I should have.

I have yet to go back to the MD and I’m looking for an endocrinologist at this time.

As far as symptoms–when on the HRT, I felt better, had a lot higher energy levels. Libido increased but was still “spotty”. I’ve been off for over 2 months now and I can tell the difference, definitely.

Question is: should I have taken the gel the day of the test? Wouldn’t that inflate the numbers or is that the way it should be?

Urologist or endocrinologist?

Thanks all

2

Androgel can be taken whenever you like; just make sure you apply it the same time everyday. Up until a month ago, I applied it at NIGHT for NINE years and have felt fine all this time. Obviously I don’t get blood tests in the middle of the night, but have usually tested between 700 to 1000 (sometimes a bit lower, sometimes a bit higher) throughout the years.

(I’m on Testim now and have gotten authorization for Testopel to be implanted this month. I switched from Androgel to Testim because Androgel was making my skin a bit dry for the past month. Besides, Testim has a better emollient (pentadecalactone) which keeps the skin moister and drives T into the skin better and faster, hence why there are usually higher T values with Testime).

You asked, “Should I have taken gel the day of the test?”

I don’t get this. You’re supposed to apply Androgel EVERYDAY. So why would you pick and choose what days you’re applying it?

You tested at 148. Most people would have been crying in a doctors office at that level.

If 7.5 grams didn’t do the job, then he should have put you at the highest clinical dosage - TEN grams - and checked to see if anything else was interfering in you getting better (prolactin and estradiol).

But then again (and I don’t want to sound like a dick here), you sound like someone who is negligent in applying everyday - indicated by your CHOICE of days to apply - and this might have been the reasons for low values.

You can go to a urologist or endrocrinologist. I see a urologist with a fellowship in andrology. I don’t want anyone who isn’t up to speed with this stuff working on me, so I’m seeing a specialist’s specialist!

Why did you stop seeing the MD, someone who actually on Androgel, proper medication for your problem?

And by the way, symptoms sometimes don’t disappear quickly. It took MONTHS to feel “OK” and a year to feel totally like myself again.

3

[quote]SportsPT wrote:
I was feeling like crap for years. I was put on SSRI’s (antidepressant) for years, but still felt off. Two-three years ago I talked to my GP who did some tests. My Test level was 148 or so. He put me on weekly injections. They were marginally helpful in upping the blood levels (up to 230 or so if I remember right).

I then decided to try a urologist. After going through his hoops I was put on 5g of Androgel daily. After a month, I got blood tests again and my levels actually went down. I didn’t apply the gel prior to the test, though). I was then instructed to try 7.5 grams per day. My levels again went up 20 points. I then got to thinking and asked if I should have applied the gel immediately prior to the test and the nurse said yes I should have.

I have yet to go back to the MD and I’m looking for an endocrinologist at this time.

As far as symptoms–when on the HRT, I felt better, had a lot higher energy levels. Libido increased but was still “spotty”. I’ve been off for over 2 months now and I can tell the difference, definitely.

Question is: should I have taken the gel the day of the test? Wouldn’t that inflate the numbers or is that the way it should be?

Urologist or endocrinologist?

Thanks all[/quote]

Low T in Texas

Some days I would just not feel good for apparently no reason. I went to my female Doc who ran some tests with blood drawn and found I had low T. She prescribed Testin which is a gel to be applied daily after taking a shower. My T has gone up and I’m feeling much better; I could tell almost immediately–2 or 3 days later and attribute it to low T. I couldn’t believe the difference. My T has been still climbing steadily but sometimes I only take Testin every other day–my bad. Made all the difference in the world to me. I’m a believer!

4

[quote]Bricknyce wrote:
Androgel can be taken whenever you like; just make sure you apply it the same time everyday. Up until a month ago, I applied it at NIGHT for NINE years and have felt fine all this time. Obviously I don’t get blood tests in the middle of the night, but have usually tested between 700 to 1000 (sometimes a bit lower, sometimes a bit higher) throughout the years.

(I’m on Testim now and have gotten authorization for Testopel to be implanted this month. I switched from Androgel to Testim because Androgel was making my skin a bit dry for the past month. Besides, Testim has a better emollient (pentadecalactone) which keeps the skin moister and drives T into the skin better and faster, hence why there are usually higher T values with Testime).

You asked, “Should I have taken gel the day of the test?”

I don’t get this. You’re supposed to apply Androgel EVERYDAY. So why would you pick and choose what days you’re applying it?

You tested at 148. Most people would have been crying in a doctors office at that level.

If 7.5 grams didn’t do the job, then he should have put you at the highest clinical dosage - TEN grams - and checked to see if anything else was interfering in you getting better (prolactin and estradiol).

But then again (and I don’t want to sound like a dick here), you sound like someone who is negligent in applying everyday - indicated by your CHOICE of days to apply - and this might have been the reasons for low values.

You can go to a urologist or endrocrinologist. I see a urologist with a fellowship in andrology. I don’t want anyone who isn’t up to speed with this stuff working on me, so I’m seeing a specialist’s specialist!

Why did you stop seeing the MD, someone who actually on Androgel, proper medication for your problem?

And by the way, symptoms sometimes don’t disappear quickly. It took MONTHS to feel “OK” and a year to feel totally like myself again. [/quote]

Excellent points! I did not take Testim the day I went to the Doc to have my blood drawn for follow-ups as I didn’t want it to possibly skew the results. I don’t know whether I should have applied it before going to the Dr that day or not. I took it later in the day after the test. So, maybe it would have read higher if I had taken it before I had blood drawn? I just assumed that me taking it daily would reflect a true reading; I might be wrong. The good thing is I feel mucho better and each time I have a follow-up the results are (T) getting higher; next check-up is in 3 months.

5

Why do people behave and talk as if gels are to be taken here and there?

Sometimes I think people on forums here are masochists.

6

“I just assumed that me taking it daily would reflect a true reading.”

Isn’t this is what’s supposed to be done - application everyday and regular blood tests to see if the medication’s working?

Dude, seriously, are you fucking retarded? I really can’t hold back on this question I ask you because of the statement “I just assumed that me taking it daily would reflect a true reading”. (Asking in a man to man way.)

What would you like? A low reading because you’re non-compliant.

And by the way, unless a blood assay is just not good, there are no false readings. You test abnormally low in T when you don’t take medication. You test normal when you take it.

Apply it the same time everyday regardless of when a blood test is done. I have no clue what your aim is.

7

And what you’re doing is actually deceptive to the doctor. If you don’t take the medication the day of the tests and consistently test abnormally low for T, he has to come to the conclusion that you don’t respond to the medication he’s prescribing and try something else, when in fact, it can be working this whole fucking time?!!!

8

Wow you guys are brutal. I took the gel everyday. I didn’t take it before the blood test only because my previous doc administered injections for 3 weeks then held for a week prior to my next blood test. It was when I had an “a-ha” moment did I ask the nurse if it should be taken even immediately before. Each time I had my blood tested, I administered the gel the previous morning and immediately after the blood draw.

I haven’t returned to the MD because of changing employers and not having insurance for two months. I have insurance now and will be back on the gel now.

So I wasn’t being a “fucking retard” or administering the drug half-assed.

9

Dude, I didn’t mean to be rude. I just asked that in a colloquial sense. Know what I mean? I mean, after all, you wrote that you assumed that taking it everyday would result in an accurate reading. I apologize if it came off the wrong way. I’ve had hypogonadism for nine years and don’t care to recollect the nightmare it was to talk around for over a year untreated; life sorta sucked then.

I’ve changed employers in the past too. Next time you know you’re changing a job, make sure to get a three month supply through your insurance company’s mail order system. Androgel can’t be gotten in three month supplies through pharmacies, but through mail order it’s fine.

10

No biggie. I didn’t post that quote, though. Chuck0303 jumped on the bandwagon for some reason. He did that quote. I actually realized what had to be done. I wasn’t given explicit directions so I based my stuff on what my prev doc said.

Thanks for the mail-order suggestion.

It hypogonadism def sucks. It took me a while to come to terms with it. My lowest reading ever was 101. That pretty much sucked and had me down for a long time.

Sorry if I came off as a sensitive man-bitch. LOL.

11

[quote]SportsPT wrote:
No biggie. I didn’t post that quote, though. Chuck0303 jumped on the bandwagon for some reason. He did that quote. I actually realized what had to be done. I wasn’t given explicit directions so I based my stuff on what my prev doc said.

Thanks for the mail-order suggestion.

It hypogonadism def sucks. It took me a while to come to terms with it. My lowest reading ever was 101. That pretty much sucked and had me down for a long time.

Sorry if I came off as a sensitive man-bitch. LOL. [/quote]

OK, cool.

I didn’t even realize who I was speaking to.

I apologize too, for flying off the handle. Although I’m not Mother Theresa, I do want to point people in the right direction and soemtimes feel like shouting, “You friggin’ nitwit - follow directions!”

12

Guys,
I was just relating my experience. Bricknyce you need to take a chill pill. My Dr appointment was early in the a.m. and it takes that gel awhile to dry so I didn’t have time to let it dry before I went to the Dr’s appointment, besides the fact that I thought I shouldn’t take it right before having blood drawn.

Apparently, I was mistaken. Now, I know for next time and I was grateful for your info, but not that uncalled for tongue lashing. I guess I should just keep my experiences to myself instead of trying to help someone else.

13

[quote]chuck0303 wrote:
Guys,
I was just relating my experience. Bricknyce you need to take a chill pill. My Dr appointment was early in the a.m. and it takes that gel awhile to dry so I didn’t have time to let it dry before I went to the Dr’s appointment, besides the fact that I thought I shouldn’t take it right before having blood drawn.

Apparently, I was mistaken. Now, I know for next time and I was grateful for your info, but not that uncalled for tongue lashing. I guess I should just keep my experiences to myself instead of trying to help someone else.[/quote]

Dude: I seriously apologize.

14

Inability to respond properly to transdermal T is a symptom of hypothyroidism. Get tested for TSH, fT4, fT3.

Check body temp when you first wake up and record for a few days. 97.8 is ideal, 97 or lower is indicative of low thyroid hormones or normal with rT3 creating a functional state of hypothyroidism. Low cortisol leads to elevated rT3.

Do you get iodine from iodized salt or from vitamins?

Yes, that is a lot to start understanding. We have many here with those issues, search for hypothyroidism in the threads of this forum.

T injections are the gold standard. Most do well on 100mg T ester per week. Read the protocol for injections sticky to understand what has to be done right to get a good result. Note that a few are hyper testosterone metabolizers and these typically need 300mg/week to get decent high range levels. It may be that their bodies eliminate T esters instead of de-esterizing, but there really is not data one way or the other.

Read the stickies on blood work, finding a new doc and estradiol.

15

Never checked temp in AM (will do tomorrow, though). Personally, I don’t think that will be a problem as I am seldom cold. Maybe this isn’t indicative of anything, though.

No vitamins. I get most iodine from salted foods (either do it myself or prepared that way–I salt to taste)

When I was on injections, I went to the doc and got one injection per week for 3 weeks and then was tested on an off week with low numbers as a result. I don’t think I was given 100mg, though. This was from my GP (don’t think he had much of a clue–no fault of his own).

16

Temp this AM was 97.4. Strength way down since being off of the gel. All other symptoms have returned also. Will start the gel today again and re-test in 3 weeks. Also seeing another urologist (closer) but not sure how that will go.

Gonna try to go to injections if he will allow it.

17

Salt used in prepared foods is rarely iodized. Are you using iodized salt? Sea salt does not contain any iodine unless labeled iodized. Kosher salt is not iodized.

18

You know what, I’m not using as much iodized salt. It’s sea salt from a grinder I believe.

19

well, I did some looking and found a guy at The Cleveland Clinic who specializes in hypogonadism. I have an appointment with him next week (Wednesday). Should I cease the Androgel 7.5 g/day until I see him or continue with it and have my blood work done with only a few weeks into the cycle?

I’m thinking the former so to have a new start with a new doc to get all of the preliminary tests out of the way. OR do I continue on it and inform the doc and have all of the tests run as being on TRT?

I was originally scheduled to go on the 28th, but had to reschedule sooner for the doc’s schedule.

20

Anyone have a suggestion?