Curious Bloodwork Results

[sirupate]

I'm sort of new here and haven't posted much. Mid-50's male being treated for hypogonadism. My endo. put me on 5gms of Androgel back in Dec., 2009. The TRT experience was pretty amazing to me until about last May, when I noticed my formerly very high libido dropping off some. The libido seemed like an easy mental marker to me of my TRT progress. Went back to the endo. a few weeks ago for bloodwork to see what, if anything, is going on. The doctor tested for several things that could have been affecting my "mood" and got the results yesterday. My testosterone results look like this:

Nov. 09 (pre-Androgel 5gms)
Tot - 221 (280-800 ref)
Free - 8.3 (8.7 - 55)

Jan. 10 (post- Androgel 5gms)
Tot - 551 (280-800 ref)
Free - 19.4 (8.7 - 55)

April 10
Tot - 649 (280-800 ref)
Free - 17.3 (8.7 - 55)

July 10
Tot - 1180 (280 - 800 ref)
Free - 39.4 (8.7 - 55)

The doctor did other bloodwork...thyroid has been normal, liver enzymes elevated, but consistantly lowering into the normal range over this period, FSH and LH normal at first test, prolactin normal at first test (too lazy to type all the numbers into the post).

Estradiol has never been tested by this doctor (need to ask him why). Since beginning TRT, I have tried to "clean up" my "party" habits some, and added some zinc and nettle to my supplements and have lost 10lbs. bodyweight while increasing muscle mass from harder workouts. There is more I can do on the diet/workout strategy. Have experimented with small amounts of an AI, but not consistantly and without an estrogen test result, don't feel confortable going very far on this front.

So...any thoughts on why total testosterone is now out of range? Free test. could even be a little higher to be optimal. Next bloodwork and appointment are in two months. Expert opinion is most welcome.

sirp

[SlimmerMe]

Welcome---you are in the right place to get some help from the experts!

[Vettester]

I think you will get more consistency and stability with your program if you were to crossover to injections. You're not the first guy to see variances like this with the gel.

Chances are your doctor doesn't believe in running estrogen labs, otherwise he would have probably been doing it for you already. I would suspect your E2 levels are elevated. I would ask to get a new set of labs that also include estradiol, DHEA, SHBG and probably check prolactin again.

You said your LH/FSH was normal on the first test. Obviously it is normal for these hormones to be suppressed when exogenous test comes into the picture. What I'm curious about is if your doctor identified why your test score was low to begin with? Maybe it's primary hypo-g in your case.

[valencia1]

I am certainly no expert but I have found that my sweet spot for libido enhancement is when Total T is between 600 and 800, (280-800 ref). I have experimented with dosages and noticed that when I got into the 1000 range I saw a drop in physical performance. My endo will NOT test for E because he says if you stay in the range you have nothing to worry about. I have argued that everyone is different so why don't we test for it and know for sure but he just tells me to back off on T dose if I get out of range. After doing so, I have to agree with him. Sometimes less is more.

[sirupate]

I think you will get more consistency and stability with your program if you were to crossover to injections. You're not the first guy to see variances like this with the gel.

Chances are your doctor doesn't believe in running estrogen labs, otherwise he would have probably been doing it for you already. I would suspect your E2 levels are elevated. I would ask to get a new set of labs that also include estradiol, DHEA, SHBG and probably check prolactin again.

You said your LH/FSH was normal on the first test. Obviously it is normal for these hormones to be suppressed when exogenous test comes into the picture. What I'm curious about is if your doctor identified why your test score was low to begin with? Maybe it's primary hypo-g in your case.

The endo told me it is secondary hypo-g. He seems to think the gel produces more consistant results. I have asked him about injecting and he is OK with that, but only in the glutes. He thought that pinning in the quad was a bad idea. We'll see where the next visit takes me, but my fear is that the endo will want me to discontinue TRT if my total test. levels stay so elevated. Really thinking that a new doctor may be needed to get me to whatever my sweet spot might be.

sirp

[Vettester]

The endo told me it is secondary hypo-g. He seems to think the gel produces more consistant results. I have asked him about injecting and he is OK with that, but only in the glutes. He thought that pinning in the quad was a bad idea. We'll see where the next visit takes me, but my fear is that the endo will want me to discontinue TRT if my total test. levels stay so elevated. Really thinking that a new doctor may be needed to get me to whatever my sweet spot might be.

sirp

He should be able to look at your results and realize there isn't anything close to being consistent. I think he says that because there is probably a lot of internal marketing (and possibly some incentive) to push the gel. Dare him to find one member on this forum that claims injections are less consistent than gel. Maybe he should listen to real time patients instead of the marketing rep coming through his door.

Nothing wrong with the glutes, it gets the job done just fine. Agree that a new doctor might be a better route.