Androgel now in use - how soon will effects be noted?

Discussion in 'Men's Health Forum' started by infoseeker, Sep 24, 2006.

  1. #1

    infoseeker Junior Member

    OK, it looks like my husband may never get around to posting here but he does read some.

    He got his hands on the androgel (10 mg. each day) and he said it's like spreading two entire ketchup packets everywhere. He knows how to let it dry, etc., all that protocol with laundry, etc.

    It's only been two days now. He has had hot and cold spells. Would the hot flashes be from dropping estrogen or something else? His lab total testosterone was only 200; this is what prompted the Rx in addition to the usual constellation of high glucose, (avg. AM 110-130, post-meal 140-180 or higher at times, A1C of 7 and later 6.1, a substantial amount of belly fat, little weight loss despite ideal diet and exercise and pretty good bloodwork re: cardiac markers. Just bringing anyone up to speed who has not read my posts - oh yes, he's 45 and has about 40 lbs. to lose, already lost 20 or 25 but SO slowly.)

    One big reason for prescribing this Androgel is in the hopes that it will give him a weight loss or at least fat loss / muscle gain (although he looks plenty muscular) push. The fat is just not coming off. We hope that will change.

    Are the sweating sessions from his metabolism changing? Also, he has not seen a return of the A.M. friend "Mr. Happy " (LOL - I think someone here typed that one time), but it's only been one full day of usage, so could that still improve in a few days, or is it not likely to improve if it hasn't yet?

    We were hoping for blood sugar levels to improve immediately (that's one other reason the dr. thought it would be a good idea) but it seems like the same-old, same-old (Oh yeah, and he's been on Metformin for more than a month and it's hardly bringing blood sugars down.) Any other beneficial or adverse effects he should watch for? Thanks.
  2. #2

    marianco Doctor of Medicine

    Androgel has to be spread in as large an area as possible in order to maximize the absorption of testosterone into the fat layer of the skin. From the fat layer, testosterone is then gradually released into the body. Too small an area of application can cause the fat layer of the skin to be saturated with testosterone. Then the rest of the testosterone will be absorbed directly into the blood stream - which does not bode well for steady levels since testosterone lasts a short time in the blood. Too small an area of application, on the other hand, can impair absorption as the testosterone dries on the skin without being absorbed.

    Transdermal testosterone reaches its peak steady state level in about 1-3 days. There are immediate effects should it be absorbed optimally. 10 grams of Androgel generally has a good chance of getting good testosterone levels. Should there be no other serious hormonal imbalance, the higher amount of testosterone can directly improve sex drive, allow morning erections, etc. The metabolic effects such as weight loss and improvement in blood sugar control may take a while to manifest. With a transdermal testosterone, one can get follow up labs as soon as a week after starting to track total testosterone, estradiol, DHT, etc.

    Testosterone can increase metabolism (e.g. stimulate thyroid activity) and skin blood flow contributing to a flushing or heat sensation.

    If a person has drops in estradiol level, then a hot flash can occur during TRT. This is more frequently seen with injections of testosterone. But it can occur with transdermals when there are not steady blood levels of testosterone - such as with high potency testosterone gels or creams or with problems with absorption (such as with thickened skin due to hypothyroidism).

    Note that testosterone can also reduce thyroid activity in some people - thus follow up to assess response is important - since in this case, testosterone can cause weight gain rather than weight loss. Also, excessive dihydrotestosterone (DHT) can also increase belly fat and weight. Excessive testosterone (this depends on the person) can increase fasting blood sugar rather than reduce fasting blood sugar.

    There are numerous interactions to pay attention to in order to optimize response. The presence of other hormone imbalances can change one's response to testosterone. Thus a multi-hormone evaluation and treatment ( if needed) is important. Follow up labs and adjustments of these other hormones may be necessary if treatment with testosterone does not work as expected.
  3. #3

    infoseeker Junior Member

    Thanks, Dr. Marianco. I'll make sure he reads this. Maybe he'll add his own update sometime.

    I know he's read everything he can about proper application and takes his time to do it right, showering and drying beforehand, allowing it to dry after, even showering at night just to make sure there's no chance anyone else will come in contact with the dried gel, even though it should be inactive by then, separating his laundry out, etc. Even so, it'll be good for him to read what you wrote about application.

    It sounds like the hot flashes are a good thing - at least something is happening. They're not severe, anyway, and it is sort or warm here (not really fall yet) and wearing two shirts might be part of it (not an undershirt kind of guy, but now he wears them - he's super-careful about the gel getting on anyone else). We'll be patient on the blood sugar. In general, he feels fine, maybe some more energy, definitely no loss of energy.
  4. #4

    mrw2k Junior Member

    Hey - just thought I'd post since I am the person you all are talking about here. Yes - I have been following the directions on the androgel and spreading it over a pretty wide area as specified in the product insert. It is a messy job but it does dry fairly quickly. I could feel an increase in energy on the first day and now that I am on day 3 I seem to be getting less of those hot flashes.
    Since this is a body building board I'd like to ask for a link to a short set of free weight routines I can use to tone up my upper arms and torso. I don't have a lot of time to spend each day but I know as little as 30-60 minutes a day can make a huge difference. Any advice would be appreciated and thanks to everyone who has posted in the past - we have found this board to be a great resource.
    Take care everyone.
  5. #5

    pmgamer18 Member

    It's good to hear your on TRT now and the feeling of hot your getting could be the change your feeling in your T levels sometimes you will get this hot feeling when levels jump up and should stop in 5 to 7 days. You don't need to shower at night if you ware a T shirt to bed I did this for yrs. and my wife never had any problems.

    When is your Dr. going to test you again most men start at 5 grams and in the insert for Androgel it states to get tested in 2 weeks to be sure your dose is working. In your case being on 10 grams I don't feel this is needed unless you start to back slide. We you do your next test do get your Estradiol tested this is the bad guy on TRT that can kill your sex life. Being that you just started I would not jump into a work out program to fast being low 200 for some time your body is under a lot of stress from the lack of T. Now that your getting T all the damage done by low T will start to repair it's self. So go slow and let your body heal start by walking and work you way up. I started walking got up to 45 min's a day got my wind back and then started going to the gym. But you don't need to go to a gym I used this link to get started but I am 62 your younger.
    There are a lot of chapters in this link every thing you need to know are in this the links to other chapters are at the bottom of each page.
  6. #6

    infoseeker Junior Member

    Just me - the buttinsky here - ;o) I think he's asking about weights because he's already been doing the walking 45 mins. or greater for years, (we have four kids including young'uns and you know how they keep you busy and active) he can do a lot of hiking even as of recently, including hills and stuff, and thus is in pretty good condition, good blood pressure etc. except that the dr. discovered high heart rate which he's a little concerned about and will follow up on in Decmber.

    I know that the dr. wants him to get his total T checked in late November. Of course he didn't write any estrogen on the lab slip but maybe he can ask the dr. to do that. It makes sense.

    We have some weights and he's been using them all along too, but not consistently. I guess he wants to get serious so that's why he's asking. Typically he's been the type who just touches a weight and his muscles bulk up. All right, I may be embarrassing him and I'll shut up now.

    [:eek:)] Our teenage boys like to use the weights also, so it's a family activity.

    Again - thanks - you guys are great.
  7. #7

    marianco Doctor of Medicine

    A total testosterone is the one test done in a basic protocol - such as the Endocrine Society's Guidelines for Testosterone Replacement Therapy.

    A basic set of follow up labs to help determine what is happening with testosterone replacement includes:

    Total Testosterone
    Free t3
    Cortisol AM
    Fasting glucose

    It's important to drink 0.5 to 0.75 liters (about 2 to 3 cups) of water prior to the lab test to avoid getting artificially higher levels due to dehydration.
  8. #8
    Marianco, why do you say that a total testosterone test is the best one to carry out, when SWALE says they are notoriously inaccurate? SWALE says that a free testosterone test is best for determining testosterone status.
  9. #9

    mrw2k Junior Member

    Hey everyone. I've been on the androgel 10mg daily for about a week. These are the effects it has had on me:
    1) Occasional hot flashes (decreasing in frequency and intensity last few days)
    2) Fat seems to be going away and muscle seems to be increasing. Weight staying about the same or going up a little. (My scale is a p.o.s. so it's hard to spot weight changes of less than 5 pounds).
    3) No noticeable change in libido or sexual function. I am puzzled by this but it may be tied in with my belly fat. As that goes away I am hopeful libido will increase.

    I am trying to maintain at least 30 minutes of exercise daily usually walking and some light weightlifting. I guess I am being impatient but I thought with a dose of 10mg daily I would see more dramatic effects fairly quickly. Would like to hear thoughts of others who have been on Androgel especially if they are Type II diabetics or suffer from metabolic syndrome.
  10. #10

    marianco Doctor of Medicine

    Actually, Dr. Crisler (A.K.A. SWALE) wrote that Free Testosterone is often inaccurate. The reason being that it measures a very small amount of the total testosterone. Measuring small amounts results in a higher risk for error.

    He uses bioavailable testosterone (testosterone bound to albumin plus free testosterone) as the measure for testosterone's activity - in addition to total testosterone.

    Free Testosterone is not accurately measured by labs. It also does not measure all of testosterone's effect on the body. Free testosterone is also not just a measure of testosterone but is the sum effect of multiple hormones including thyroid, estrogens, progesterone, insulin, DHEA, growth hormone, and testosterone, etc.

    If total testosterone is low yet free testosterone is high, then there may be significant problems with these other hormones for which treatment with testosterone is not a complete treatment.

    Bioavailable testosterone is a better measure of testosterone's activity. The testosterone bound to albumin is loosely bound and is active.

    Total testosterone (I believe) is an even better measure because testosterone bound to SHBG is still active. It is active on SHBG receptors, not testosterone receptors.
  11. #11

    infoseeker Junior Member

    Come on, guys - he's talking about boners here, pardon my French. A year ago - even six months ago - he had boners to spare. Now they're iffy and/or pretty much gone (talking about those legendary AM ones.) So now we've investigated, found a testosterone deficiency, added 10 mg. per day of androgel, and the boner action is not forthcoming.

    He assures me I'm hotter than hot - that's not it (that's the insecure female's first thought and biggest insecurity.) He doen't have any psychological complex. So what, hormonally, can be wrong? The dr. has found no evidence of structural problems (blood vessels and heart in great shape.) Thanks for any suggestions. I think he does plan to ask for the dr. to order (or order himself) a more detailed workup, so what should he specify: estrogen, any sort of breakdown in androgens, or what? Any ideas, anyone? THanks.
  12. #12

    mrw2k Junior Member

    Yes - "Boners to spare"! That's what I don't have right now. I'm tired of those iffy boners.
  13. #13

    pmgamer18 Member

    I think we have said this from day one to get his Estradiol tested even before he goes on gels but I talk to so many men I may not have told you this. But still this is what kills sex gives him ED so get it tested and do a test like this one.
    And read this.

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