On HRT but are numbers optimal?

[SoCal91]

I've been on HRT for a number of years...about 5, because of Low-T due to one non-functional testicle. I'm now 38, and earlier this year my primary doc bumped up my Androgel to 4 pumps of 1.62%, which is about 80mg/day. I was on 50mg/day with the 1% packets. I was still not sure my levels were optimal, so I saw an endo at work and he ran a bunch of tests on me with Quest.

Albumin 4.7 3.6-5.1 g/dL
Globulin 2.7 2.1-3.7 g/dL
TSH 1.56 0.4-4.5 mIU/L
T4, Free 1.3 0.8-1.8 ng/dL
Test Free/Total LC/MS/MS 620 250-1100 ng/dL
Test Free 110.0 35-155 pg/mL
ACTH, Plasma 14 6-50 pg/mL
LH 1.2 1.5-9.3 mUI/mL
PSA 0.6

He went over the results with me, and said things look OK. I still have some ED issues and for a while still feeling tired and a bit drained, but that could be due to work stress. I do get about 7.5 hours of sleep a night. I have gotten some acne as a result of the HRT. I've seen elsewhere that 'optimal' free T levels are noticably higher than mine. But both of my docs (PC, Endo) are happy with my levels.

Thoughts? Should I shop around for another doc, or complain louder to my endo? He said for higher T does he switches people to shots, as the gel gets too messy. Due to a little extra left in the pumps, I get in one extra pump a day for most of the month so in reality the does is close to 100mg. But I haven't had blood work since I started using up all the gel each month instead of getting refills slightly less often.

[edmundo22]

There was no check for estradiol (E2)? E2 too high or too low results in ED and symptoms associated with low T.

[steroid.com 1]

What Ed said on the E2...a must have!

You're ED could be caused by elevated E2 but gel/cream users generally don't have these issues simply do to thier delivery mechanisms.

Besides that, you look good.

I'd go with injections if your Doc is open to that...many more benefits.

[SoCal91]

Nope, no E2 anywhere on the lab results. What are the benefits to injections? Gel is quick, easy, and painless. Insurance is excellent, so it's dirt cheap too.

[edmundo22]

Your never guaranteed full absorption with gel plus your more likely to have higher T levels on injections as its a far more effective delivery system, personal preference I guess I'd much rather have a single shot weekly then applying gel 15 minutes daily, shots are way cheaper then gels.

[kelkel]

Op on your next BW be sure to get your DHT level tested to see where your at. Gels tend to increase it and it will act as a natural E suppressor on 3 different levels. Also test your vit D level as most all are low. If your not already supplementing with it start doing so. Proper D levels will ultimately increase your free T by reducing shbg.

Another thing to try if you stick with gels (I've been there) would be to apply moisturizer about 1 hr after application of the gel. It improves absorption by up to 14-17% if I remember the numbers correctly. It was originally stated right on the agel insert. Just cease it prior to BW so you know normal levels. Speaking of BW, was your pulled 24hrs after application at trough level or some other time?

When it comes to ED have your tried Cialis for daily use? It has many benefits beyone the high hard one. If you have good insurance it probably covers it. Mine does for two a day actually. Approved for BPH, nitric oxide booster, much more: Read this: http://www.fda.gov/NewsEvents/Newsro.../ucm274642.htm

Also consider HCG for obvious reasons. Read GD's sticky thread on it!

And personally, I vote for injections hands down.

[SoCal91]

Kelkel, thanks for the info! My doc did test for D levels, and they were low back in Feb (27 ng/ml). So he put me on 2000 IU a day to try and get me over 40. I got BW done in May, but haven't gotten the results yet. I did actually read the insert about moisturizer, and due to my work schedule I apply moisturizer about 15-20 min prior. I know the package talked about applying it after. My BW was done around 9am, which was about 2.5 hours after application.