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Discussion in 'Men's Health Forum' started by xray9, Aug 30, 2008.

  1. xray9

    xray9 Junior Member

    Hi everyone. I've been on HRT with 5g androgel for five weeks. I'm 45 years old, 5'9", 250 pounds, muscular build with excess body fat and have been diagnosed with primary hypogonadism. My left testicle is less than half the size of my right. My PCP felt it and said that everything was still connected and there are no variocles but the lack of size likely indicated it was not functioning normally. Two blood tests six months apart indicated that total and free T were both in the low normal range. FSH, LH, E2 and thyroid function results were all nominal. I didn't get a copy of my results but remember that total T was in the low 300's on both tests. Upon my request and after a long discussion my primary care physician prescibed Androgel.

    The effects of the Androgel were almost immediate and extremely beneficial. I have been treated for depression for ten years with very limited results from a variety of antidepressants. In the past year I have also suffered from low libido and erectile disfunction. Many days after work I had been so tired that after work I would eat dinner, watch a little TV and then crash at 8:30 or 9:00. I tried exercise but never had the energy to stick with a program.

    After taking the Androgel, 4 pumps per day, my energy levels tripled, my depression lifted, my libdo and sexual functioning returned, and overall mood and mental acuity increased substantially. I felt ten years younger.

    The only negative side effect I had was a feeling of being too hot and flushing in my face and upper body. After searching I can't really find definative information on testosterone and flushing or flushing in general. I just assume it is a result of high amounts of Test. The flushing wasn't super noticable or uncomfortable, just as if I had been in the sun recently.

    Now in my fifth week the flushing has gone and I am getting very mild chills when the room is 72 degrees. I took my temperature a couple of times and it is around 97.2 to 97.5. Also my libido and energy have decreased somewhat but not to the levels they were prior to HRT. I have maintained resistance training three times a weeks which I began when I started HRT and my strength and endurance have increased substantially. However, it seems to take more effort to get throught the workouts.

    I have been lurking this forum for about a month now and am impressed with the quality of information and discussions. I particularly like the fact that physicians read and post here.

    If you're still reading thanks for bearing with my long windedness. I would appreciate your input on a few questions I have:

    Is it likely that my HPG axis has decreased endogenous production of T?

    Should I increase my dose of Androgel, I get my script filled six days early so that would be an extra pump per day?

    I tried applying Androgel to my scrotum and experienced only a mild warming sensation, nothing bad. From what I have gathered reviewing available research, T absorption is five times greater in the scrotum area. DHT conversion will be higher there but I welcome the viralizing effects since I don't have much beard growth and have moderately high pitched voice. Also higher DHT generally means lower E2 though I forget the exact mechanism. And I have a full head of hair and no male pattern baldness in my family. Are there any negative consequences of supraphysiologic DHT beside prostate affects? Any reason for me not to apply Androgel to my genital area / inner thighs contrary to the packing insert?

    Any ideas on the flushing / body temp? A search of posts indicated it is fairly common.

    My next blood test is in two months. Should I go see my doc and be tested sooner or titrate the dose myself? She had said that she would not be opposed to increasing my dose.

    AAS using bodybuilders typically cycle T at 600 mg per week, about ten times the highest recommended dose of Androgel ( or the body's high normal range limit). What would be the effects of long term supraphysiologic administration of Angrogel, say at twice normal without "cycling" on and off?

    On HRT will endogenous production necessarily be shut down? Should hcg be perioidically used to restart it? Why or why not? Can you just shut it down forever? Long term effects?

    I would appreciate any feedback.

    Thanks
     
  2. pmgamer18

    pmgamer18 Member

    It would still be good to get copy's of your labs and get them every time you have one.

    Here is the problem you started on a low dose 5 g's of androgel so this might have upped your testosterone levels 300 more points I am saying just to show you what can happen. So your brain sees your levels went up and you feel better. But your brain seen your Testosterone levels went up and slowed down your LH and FSH message to your Testis to make Testosterone. So now your testis will stop making that say 300's your labs showed and you fall back to a level that the gel is doing so you might be even lower.

    This is why when men start on androgel they need to do labs in 2 weeks so you can see if this is going on and up the dose. I don't feel you should do this with out your Dr. You need to do this with labs so yes go get tested again first and because you feel this way after you do your labs up your dose.

    If your labs come back and you are low you ahead of the game.

    The flushing can be your levels falling back down we feel symptoms when levels fall. Also this can happen when Testosterone levels are going up. But when you level off this stops.

    Looking at your temps shows me you can be low on your Thyroid. The true test for this is Free t3, Free T4, RT3, Ferritin and Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
    Also you need to test your Adrenals for low Cortisol levels you can do this in a morning fasting blood test if your below 15 then get a Saliva test one that tests you 4x's in a day.

    You can't treat a low thyroid if your Cortisol levels are to low. You need cortisol to carry the hormone out of your blood into your cells. With low cortisol it will build up in your blood and make you feel worse.

    If your Dr. ups your gel dose test in 4 to 6 weeks again if still to low switch to shots. Your skin is not letting the testosterone into your body. Start with 100mgs every week and test in 6 weeks. If your Total and Free T levels are not up into the upper 1/3 of your labs range up your dose to 120mgs.

    And keep testing your Estradiol levels try to keep them down between 10 to 30 best at 20 pg/ml.

    Don't put the gel on your testis doing this only drives your DHT and Estradiol levels way up and it's dam hard to adjust your meds to get and keep you leveled.
     
  3. xray9

    xray9 Junior Member

    Thanks for the advice. I'll make an appointment to go ahead and get lab work done now rather than wait another two months. I'll ask for the thyroid and adrenal tests as well, and get copies of all tests so far. That way my PCP and I can see what's going on rather than guessing.
     
  4. JanSz

    JanSz Junior Member

    t3 Free
    T4,Free
    reverse T3 (rT3)
    Ultrasensitive TSH
    Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
    iodine
    copper
    selenium
    zinc
    Cortisol AM/PM
    DHEA sulfate
    prolactin
    Estradiol, Ultrasensitive, LC/MS/MS (30289X)
    testosterone, Free, Bio/Total (LC/MS/MS)
    Dihydrotestosterone (204X)
     
  5. xray9

    xray9 Junior Member

    Thanks, now to lookup what these tests mean / normal ranges.

    After a couple of days off work I'm feeling very well. Happy Labor Day! I work six days a week and think I was just a little burned out. No more flushing or hot flashes and temp is normal.

    I believe I need to fight the tendency to micromanage HRT. While being informed is good and some tweaking may be necessary, since I'm new to HRT I tend to attribute every mood and feeling to hormone levels and want to make adjustments. Overall I feel so much better on androgel that I think I'll keep things consistent for a while and try to avoid "more is better thinking".
     
  6. pmgamer18

    pmgamer18 Member

    We do feel better on days off this is why we don't do labs on them days off. Here is what works and it's in this link I am giving you. All you need to do is get your Total and Free T levels up into the upper 1/3 of your labs range for a young man then go by how you feel. Also keep your estradiol down between 10 to 30 best at 20 pg/ml doing this will have you doing your best on TRT.

    Now if you find you have more problems like Thyroid and Adrenal Fatigue low cortisol levels treating them will put you at your best.

    Male Hormone Modulation Therapy.. HGH replacement, Testosterone Replacement

    Here is a good link on Adrenal Fatigue and how you can make changes to help with this.
    Coming Soon...

    If you find you have a low thyroid and Cortisol levels read how I got started treating this.
    realthyroidhelp.com • View topic - How I got started treating my Adrenals and Thyroid.

    Also to give you an Idea how hard it is to find a good Dr. to test and treat you it took me 23 yrs to get this all figured out your can read my story at this link.
    Stop The Thyroid Madness Phil’s Story