6 weeks into TRT, labs show Test is lower?

[Lockout888]

I'm just over 6 weeks into TRT via Axiron (2 pumps a day). My total testosterone shows lower than before I started? Can anyone shed some light on this?

Initial Labs:
Total Test = 291 (241-827)
T4 = 7.4 (4.5-12.0)
TSH RFLX = 2.61 (0.40-4.50)
LH = 5.4 (1.5-9)
FSH = 5.2 (2.0-9.2)
Estradiol = 13 (8.0-35)
Progesterone <10 (<10-11)
Prolactin = 4.8 (3-18)
Estrone = 64 (12-72)
SHBG = 17.0 (16.5-55.9)
Albumin = 4.8 (3.6-5.1)

6 weeks later:
Total Test = 234 (348-1197)
LH = <0.2 (1.7-8.6)
FSH = 0.5 (1.5-12.4)
Estradiol = 19.8 (7.6-42.6)
SHBG = 14.8 (16.5-55.9)
Albumin = 4.3 (3.5-5.5)

[kelkel]

Some people just absorb poorly. Double your dose (with doc's permission) and re-test in two weeks. Your initial LH/FSH levels appear good. Were you diagnosed as primary hypogonadal? If not, what was the diagnosis other than low T?

[jomamma007]

As Kel said, some people absorb poorly. You should save yourself the hassle and switch to injections if you can.

[Lockout888]

Some people just absorb poorly. Double your dose (with doc's permission) and re-test in two weeks. Your initial LH/FSH levels appear good. Were you diagnosed as primary hypogonadal? If not, what was the diagnosis other than low T?

High Cholesterol, low T, low vitamin D and metabolic syndrome.

Just spoke with my Doctor and he says I'm aromatizing and my liver is dumping the excess estrogen. He is not recommending increasing the dose of Axiron, but taking 1mg of anastrozole daily.

Does this sound correct?

[kelkel]

High Cholesterol, low T, low vitamin D and metabolic syndrome.Ouch. A hat trick

Just spoke with my Doctor and he says I'm aromatizing and my liver is dumping the excess estrogen. He is not recommending increasing the dose of Axiron, but taking 1mg of anastrozole daily.

Does this sound correct?

No. Your estrogen level appears fine. Especially if that is a sensitive assay. 1 mg of Adex daily is basically a breast cancer dosage and ridiculous. Example for you. Most guys on a test cycle of 500mg per week will use .25mg adex (anastrozole) every other day. Do the math there. Does it sound correct when put in perspective like that? That will crash your E to nothing and then you will feel far worse. Your doc is guessing IMHO. You need to up your dose or switch to an injection protocol. All this assuming nothing else is contributing to your issues.

Definitely begin supplementing with D3 if you haven't already. If you're not on cholesterol meds look into Slo-Niacin as a way to improve your levels. Google LEF.com and Niacin and it will come up.

BTW, welcome to the forum!

[jasondd1]

Im curious what your dht level is?

[kelkel]

Im curious what your dht level is?

Me as well, but problem is most people don't have pre-TRT DHT levels to compare it to.

[Lockout888]

Thanks guys. I took the blood test at 7am, without applying any Axiron. I usually apply it around 7:30am. Is that when I should have taken the test?

[The Deadlifting Dog]

from the Axiron insert:

• Dose adjustment: The dose of testosterone may be decreased from 60 mg
(2 pump actuations) to 30 mg (1 pump actuation) or increased from 60 mg
to 90 mg (3 pump actuations) or from 90 mg to 120 mg (4 pump
actuations) based on the serum testosterone concentration from a single
blood draw 2 – 8 hours after applying AXIRON and at least 14 days after
starting treatment or following dose adjustment. (2.2)
•

I see a lot of confusion on this website on this matter.
One draws blood AFTER applying a transdermal. This is done so one can see how well one is absorbing the medication.

Since testosterone has a short half-life (10-100 minutes), most of the testosterone is gone by 24 hours after application. Hence the reason for the daily application.

Please see the attached charts showing test levels after applying Axiron and the est levels of a normal healthy male.

[kelkel]

Quite honestly you should be able to pull BW anytime and be fine with an astute doctor.

[dreadnok89]

Axeiron is pretty lame. I stopped using it

[Lockout888]

Axeiron is pretty lame. I stopped using it

I'm thinking the same thing. I bumped my dosage to 4 pumps a day and got blood-work 2 weeks later. It looks like I can't absorb this stuff:

Total Test = 334 (348-1197)
LH = <0.2 (1.7-8.6)
FSH = 0.4 (1.5-12.4)
Estradiol = 23.5 (7.6-42.6)
Albumin = 4.4 (3.5-5.5)

[Rusty11]

Looks like the Axiron isn't cutting it. Time to have another discussion with your doc.
I'm surprised he would recommend an ai with your reasonable e2 levels. Did you decide for or against the ai?

[Lockout888]

Looks like the Axiron isn't cutting it. Time to have another discussion with your doc.
I'm surprised he would recommend an ai with your reasonable e2 levels. Did you decide for or against the ai?

I'm actually looking for a new Doc that knows what they are doing. My PCP originally found my T level was low - so she prescribed 1 pump of Axiron. I feel like she doesn't know much about the subject, so I started looking for a TRT Doc in my area.

I went to a new Doc who was supposed to specialize in TRT, but I'm not really happy with his advice either. He's the one who recommended the AI, not increasing the dose. He has a concierge practice and charges $150 a month just to be a patient, so I stopped going to him.

I think I found someone - he is an MD and A4M certified. From his website it looks like he is knowledgeable. If not, I may consider the website in the sticky.

[Rusty11]

That's great that you were able to find a doc who is A4M certified. Hopefully, you'll be in good hands. Let us know how it goes...and good luck.