40 yo male need advice on HRT

[djsingsing]

I have another post in the 40 YO forum. Long story short, I started andro gel back in 2008. I was fairly overweight and low libido. I had been working out for years, lifting and cardio, but with very low results.
My first BW showed 99 ng/Dl. Very low. I went on andro gel and know how to dial it in to a particular level. I am keeping it around 600 now, but have had it as high as 1400. The andro gel is working great for me...have figured out some fairly clever tricks to it. if interested I would be happy to post.
In the last 3 years, I have gotten much stronger and leaner, although not where I could be with more discipline and better diet. My bench ~275, cannot squat right now due to some knee problems. But that gives you an idea, I am not weak, but not where I want to be yet.

What I need help with is, my energy and libido have been very low again for the last several months. I have read through several threads here and I dont think the Dr. is testing everything he should....ex:
no estrogen, T3,T4, dhea, gh testing.

My question is, what specifically should I ask him to test?

Here is what I have results from that are all in the normal range:
glucose, BUN, creatinine, sodium, potassium, chloride, carbon dioxide, calcium, protein, albumin, globulin, A/G ratio, Bilirubin, Alkaline Phosphatase, SGOT, SGPT, lipid panel, Complete blood count and test.
I can post results of each of the above, they are all in the normal range, but I dont think these are what I am looking to dial in...correct?

I did call a local anti-aging institute for a quote...I will start another tread on that.

[kelkel]

First, welcome to the board. Go to this website http://www.allthingsmale.com/publications.html. Dr. Crisler has pretty much produced the bible when it comes to TRT treatment. He has a section on BW there that you can use as a guide. He will also confer with your doctor for a fee to help guide you. Out of wack E is very possibly your problem as it creates many sides you don't need. When you do get your E tested it needs to be a sensitive assay, not your standard E test. I'm sure you need an AI as well as HCG also.

I happen to be one of the few here that also have stuck with the gel so far with positive results. I'd be very interested in the "tricks" you spoke of. If you don't want to post them, PM me please.

There are a lot of members here with high knowledge levels (like Dr. level) when it comes to bloodwork, AI's, HCG etc. They will respond and you will learn alot from them. They are really well versed and have taught me more than any doc/endo I've seen so far......

[zaggahamma]

from what you posted.....most important would be e2/estradiol which looks like could be the culprit....and YES...please do post your gel secret(s)....if its legal

[djsingsing]

On the Gel tricks, I have figured out several over the last few years.
1) make sure you get the PUMP, not the packets. I have found the pump actually has ~75 metered doses rather than the 60 as listed on the bottle.
2) Most do this (I have several friends on this per my advice), but be sure and break the top off the pump and squeeze out every last drop of the gel...I suspect with this you get about ~80 pumps
2) make sure your dr prescribes 5 pumps or more per day on a 90 day script. 5 is the cross over where they have to give you 8 bottles for 90 days, so a bit extra.
3) switch up the sites where you apply as it seems that the skin builds up some sort of "resistance" to absorbing. My favorite spot is from the inside of your arm from your wrist to upper triceps. it seems to absorb very well here.
4) split the applications, do 1/2 of your daily in the morning and 1/2 before bed. seems to even out better for me that way.
5) Since I have been on for 3 years, about a week before I would go to the dr, I would do a specific number of pumps to see the tst increase with each. Now, I am sure this is not 100% accurate, but I got the number of pumps to reach X tst level...for me:
before treatment tst = 99 (way way low)
3 pumps: ~275 (still low)
5 pumps ~500
8 pumps ~800
12 pumps ~1400
so not exact, but each seemed to bump me by 100 (I try to keep it around 700) this is possible with a 5 pump script using the above two tricks.
6) I take a break every now and then...I dont stop cold turkey, but cycle down every few months. slowly down for a couple of weeks, off for 2 weeks then back up over two more weeks. I have no idea if this is necessary, but it seems like it always comes back up stronger could be mental .
Its nothing magic, but this seems to have optimized the levels for me...now to add the rest.

[JD250]

Thanks for the tips, there are some here that use the gel, you definitely need to have e2 checked "sensitivity assay" e2 will ruin your day if it's messed up. Good luck bro.