Follow up appointment today - need advice!!

[buckeyes#1]

Copying from another board because I cannot post to that one from work.

I had blood work done at my physical last month after complaining of fatigue, weight gain, loss of energy, etc. My results were: TT 273 ng/dL (280-1000)
FT 11.9 ng/dL (8.7-55.)
TSH 1.89 mcIU/mL (0.32-5.00)
The rest of my bloodwork (cholesterol, glucose, etc) came back normal.

My doctor left me a message that although I was low, I was pretty much normal. I wasn't buying it. I am only 30 y.o. workout 4-5x a week and try to eat sensibly. There was no way my test levels should be equal to a 100 y.o. man's. I asked to have a second test done and she wanted this one done in the afternoon. So I went back in a week later and my results were: TT 205 ng/dL
FT 9.4 ng/dL


She wrote me a Rx for 5g of Androgel and wants me to come back in next week for more blood work. Unfortunately, I did not know about LH or FSH or any of the other things that I should have had her check prior to starting the Androgel.

I felt better after a few days of taking the gel (placebo effect?), but that has reversed and I feel just as bad, if not worse. I am still tired throughout the day, my workouts suck, can't remember the last time I had morning wood or any sex drive.

**Two weeks after I started Androgel**

I got my blood work drawn two weeks after I started the AndroGel. I have not felt any better in any way whatsoever. It is kind of frustrating. I actually feel like from all of the researching and reading I have done that I may understand low testosterone better than my own doctor.
My results were: TT 258 ng/dL (280-1000)
FT 9.0 ng/dL (8.7-55.)

I also had her check my cortisol, estradiol and run a full thyroid panel. My estradiol was a 20, but I do not remember the other numbers. They are at my office. I know my TSH was low normal, but T3 and T4 were in the middle of the range.

I have an appointment scheduled for Wednesday and am going to request IM shots. I have to put my gel on in the morning and then get my kids ready and transferring it bothers me. I just have a feeling that after my meeting on Wednesday that I will be looking for a new doc, thus prolonging the hunt for normalcy.

Any advice on what I should talk to her about or more tests for her to run? I am still tired, yawning all day, no morning glory, no libido, etc. Luckily I have a good workout partner who won't let me wimp out in the weight room. Just really frustrated.

Do you recommend me asking to be referred to an endo or urologist? Who would be more up to date on HRT?

[CrazyCrew]

Some (like me) do not respond well to Androgel. She started you on the lowest dose as well. See if she can order a compounded gel. It is cheaper and stronger. HCG will definatly be necessary and will boost your natural production.

good reading;
http://musclechatroom.com/forum/showthread.php?t=33
http://musclechatroom.com/forum/showthread.php?t=34

[Vettester]

Don't feel alone on this issue. You'll see that there's thread after thread with similar stories about doctors basically brushing this stuff off, and plenty of stories involving the old AndroGel Shuffle Syndrome (ASS). I was on AndroGel for several months and then my blood work numbers started going all over the place.

By the looks of your numbers, you shouldn't have any troubles getting on a solid HRT program. I think just about everyone here will point you towards getting Test injections, once per week if possible. It might come down to making a choice and going to see another doctor like an Endo, or even going to a specialized clinic in HRT. I ended up going the clinic route just because of all the BS between both my doctor and even the Endo. It costs more $$, but they're spot-on with my program, and it includes AI, HCG, which my original doctor looked at me with blank eyes when any of this was brought up.

Please, let us know how you make out.

[THORSZ]

I had a very similar story. I went on gel for a couple weeks and told my doctor i wanted injections. She gave me every reason in the world why she couldn't and then finally told me they just don't monitor blood levels for injections. What the hell?
Anyway, I called a doctors office I used to go to and asked the nurse if they did injections. She said they have done so with a few people so i booked the appointment. By the time I saw the doctor a month had past. He tested my levels and 5g of androgel a day actually lowered my levels further below 200. I requested injects. He pushed back at first, but i told him my wife wouldn't let me touch the kids if I didn't shower first. That did the trick and i went on test-C. Hang in their bro and take charge like you are. I have been on exactly a year and never looked back.

[buckeyes#1]

Unfortunately, I went to the doctor yesterday only to be told that my appointment is today. I know for a fact the secretary told me the wrong day because I had cable installed last night and was afraid of the time conflict. Small things like that just put me in such a sour mood. At least I get to leave work early again today.

[buckeyes#1]

I knew what was going to happen and I still spent the money for my co-pay.

I answered a million questions about my diet, exercise, sleep habits, etc for a medical student of my doctors. The doctor finally comes in and is just so puzzled that I have had no change since starting the Androgel. She tells me there are other options, but since I didn't have a change with the Androgel that the shots probably wouldn't do anything for me. She then goes on to tell me that the testosterone shots will cause my testicles to shrink, I will grow boobs and will be mean to everyone. I just laughed. I wonder f she even realizes that Androgel is the same f'ing thing just in a different delivery method.

I go on to explain that I very rarely have morning erections any more and that my wife and I have only had sex like 6-7 times in the past year or so. She mentions that morning wood is not the norm. Where the hell do these people get their degrees from?

So in conclusion, I was able to get her to refer me to a urologist. I made sure to tell her that I only want to deal with someone that treats testosterone issues on a frequent basis. I also had to request her to up my Androgel to 10g until the appointment with the new dr. She didn't understand that if I just stop that my test levels may decrease because my body is relying on the supplemental test.

Can't wait to get in and see the urologist.

[Vettester]

My original doctor was also a female. She too mentioned the old roid rage concern. I told my doctor if it is such a bad thing, then why do sooooo many people take it and have nothing but good to say about it? Your doctor, like mine, showed her cards that she doesn't know sh.t about this area. Hopefully the new doc will help you, but if he starts waffling the subject and suggesting to stay on your current path, then you should seriously consider taking a new route with someone who can properly medicate you. Tell the doc she can wax her car with the AndroCrap.

Good luck!

[THORSZ]

That is the problem. I have heard so many guys complain that female doctors give them the run around. I started with a female doctor too and moved on to a male doctor.
Funny, they Will put a woman on estrogen at first sign of menopause, but men should live with basically no test production. She doesn't have a clue.

[buckeyes#1]

So I made it in to see the Urologist last Thursday. Answered the same questions about diet, exercise, etc. He seemed to be a little more up to par on the subject than my regular doc. He talked to me about the various types of testosterone available. He seemed to be favoring the injectable pellets, but I do not think I want to go that direction.

He said he will get my levels to where they need to be. Then the killer statement, "I would like to see your levels up to at least 4-500." I did not say anything, but figured we would deal with that hurdle when we get there. I complained of still being excessively tired, lack of libido, no morning glory, etc.

He ordered some bloodwork and here are the results:

FSH 0.4 (1.0-12.0 mlU/ml)
LH <0.1 (2.0-12.0 mlU/ml)
Prolactin 13.4 (1.6-18.8 ng/ml)
Free Test 21.4 (8.7-55.0 pg/ml)
Total Test 484 (280-1000 ng/dl)

I had been on 10g of androgel for two weeks prior to this labwork and I did apply the dosage that morning. I explained to him that I would like to switch to something else because of the hassle of having to apply it, then trying to get my kids ready in the AM. Need to schedule a follow-up appointment.

So should I be feeling better? Or is it possible I still need to go higher to hit my target zone for the test?

[buckeyes#1]

bump for answers

[Vettester]

I personally just didn't like how I felt on AndroGel. Even though this doc is talking a little better ballgame than your first doc, it sounds relatively similar. Testosterone is a prescription, irregardless, so why doesn't he just give you a weekly setup with some T-Cyp and be over with it? Why do these docs just have to have all the control? Is he also talking to you about meds for the LH side of it, and AI as well? I think my last total test was 895 or something close to that, and my HRT doc said that is great! 400-500 is a little conservative in my opinion, but obviously it beats 200 or 300. What's he afraid of if you get to 700 or 800, does he think you'll explode or start ripping your skin off? I don't know man, I might consider going to the next door with what you're telling us. But, if you're going to see him again then hear him out and see if he'll do the same.
Let us know what happens (thanks).