Transdermal Experience

[nuker]

I have been on Androgel for over a year. A few months ago, I was noticing that Androgel had rapid absorption and short duration of action. I felt edgy shortly after application and felt that I ran low about 4 hours later. My doc at the time wanted to double the dose but admitted that TRT was beyond his expertise.

I switched docs and was put on Testim. With Testim, I don't get the edgy rush I felt with Androgel but the duration is still only about 5 hours.
On Testim I'm cranky and I notice my memory is poor in the morning and later in the day. I only feel good for about 5 hours.

Has anyone had a similar experience where they just don't get the duration they need with the transdermals? I apply the product to my shoulders. Would a different spot be better? Is there anything else I could be doing?

T blood levels are below 180 at around 20 hours after TD application.

I can't seem to find a doc near me with much experience with TRT.

 

[JanSz]

I have been on Androgel for over a year. A few months ago, I was noticing that Androgel had rapid absorption and short duration of action. I felt edgy shortly after application and felt that I ran low about 4 hours later. My doc at the time wanted to double the dose but admitted that TRT was beyond his expertise.

I switched docs and was put on Testim. With Testim, I don't get the edgy rush I felt with Androgel but the duration is still only about 5 hours.
On Testim I'm cranky and I notice my memory is poor in the morning and later in the day. I only feel good for about 5 hours.

Has anyone had a similar experience where they just don't get the duration they need with the transdermals? I apply the product to my shoulders. Would a different spot be better? Is there anything else I could be doing?

T blood levels are below 180 at around 20 hours after TD application.

I can't seem to find a doc near me with much experience with TRT.

Looks like you are not absorbing neither Androgel or Testim.
What dose are you using.
Are you really really careful, so you do not spill the gel on the floor?
There is whole crowd of people with your experience.
Standard answer is that most likely it is due to thyroid problems.

I am guessing that there may be another reasons.

If you have blood tests, you may want to post complete blood tests here.
complete name, number, units, range, what laboratory have done the testing, detailed description of when (time) you have drawn your blood in relation to your usual time when you apply the T.

 

[nuker]

I am careful to apply every last bit. I am sure that I have the application process down for these two TD's. Rubbing in the Testim and applying the Androgel. I let both dry a good while before covering.

My last blood work:

Total T: 161 ng/dl 241-827 range
Free T: 0.33 ng/dl 0.72-2.30 range
%free T: 0.20

This was @ 20 hours after application

Same day thyroid function panel:
Free Thyroxine: 1.1 ng/dl 0.9-1.8 range
TSH: 0.74 iIU/ml 0.35-5.5 range

Blood lipids, renal function, blood chemistry normal.

No other meaningful tests were run.

Thanks!

 

[JanSz]

I am careful to apply every last bit. I am sure that I have the application process down for these two TD's. Rubbing in the Testim and applying the Androgel. I let both dry a good while before covering.

My last blood work:

Total T: 161 ng/dl 241-827 range
Free T: 0.33 ng/dl 0.72-2.30 range
%free T: 0.20

This was @ 20 hours after application

Same day thyroid function panel:
Free Thyroxine: 1.1 ng/dl 0.9-1.8 range
TSH: 0.74 iIU/ml 0.35-5.5 range

Blood lipids, renal function, blood chemistry normal.

No other meaningful tests were run.

Thanks!

Thyroxine (T4) Free, Direct, Serum

When testing thyroid always do
FreeT4
FreeT3

Well you are low on Total testosterone.
Ask doctor for

DepoTestosterone and HCG, probably few other items when I see your blood test.

also good blood test, see test that I do, post #44:
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

If you have your current SHBG then I can calculate approximate starting dose of shots for you.
Further adjustments will be made based on your then current blood tests.

 

[nuker]

The lab used was ACM Medical Labs.

www.acmlab.com

 

[nuker]

I'll need to find a doc that will write for injectable. The current doc, a urologist, offered once a month injections in the office as my only option. I tried to explain the pharmacokinetics and suggested weekly or twice per week injections and he sort of blanked out on me. He was cordial and everything, I just think he was out of his knowledge base.

Is anyone using a doc in the Rochester, NY area?

 

[JanSz]

The lab used was ACM Medical Labs.

www.acmlab.com

Make an effort to use Quest Diagnostics.

If not you are into translating

http://www.labtestsonline.org/

 

[nuker]

ACM is the only one covered by my insurance. I should go see Dr. J. It's about a 7 hour drive from here.

 

[JanSz]

ACM is the only one covered by my insurance. I should go see Dr. J. It's about a 7 hour drive from here.

Good choice.

Post ZIP of your location, possibly we can do this together.
I am ZIP 07054

 

[wondering]

I live in Rochester and have convinced my PCP to consult w/ Dr. Crisler. Awaiting results from 24 Urine and follow-up VOV w/ both of them. I am optimistic as my PCP was apprehensive at first, but after talking w/ Dr. Crisler said he felt a lot more comfortable and "he knows a lot more about this stuff than I do".

so my PCP doesn't really know what he is doing re: TRT, but I think his mind is opening to the idea that this is far more complex than - take this shot and if this doesn't work, then it's all in your head. That's what I got from my endo - what a jerk he was.

So.. if this goes well, I'll be happy to share me PCPs name and you can see if he is still accepting new patients. Not sure if you are interested in switching PCPs.

But, please understand my Dr. is new at this and I don't want to scare him off by sending new patients at this point. Let me get my care underway first. If you don't want to wait I understand, but I've been going thru he!! for 12 years and I'm just not ready to freak my doc out by sending other folks his way yet. Let him experience a success story w/ Dr. Crisler and then we may have another doc to add to "recommended list".

I'll need to find a doc that will write for injectable. The current doc, a urologist, offered once a month injections in the office as my only option. I tried to explain the pharmacokinetics and suggested weekly or twice per week injections and he sort of blanked out on me. He was cordial and everything, I just think he was out of his knowledge base.

Is anyone using a doc in the Rochester, NY area?

 

[ItsHectic]

I am on testogel and my peak level before arimidex was about 720ng/dl and my baseline about 20 hours after was 250ng/dl. If your baseline is that low it doesnt neccesarily mean your not absorbing it.
One purpose of HCG is to bring up the baseline level.

 

[JanSz]

I am on testogel and my peak level before arimidex was about 720ng/dl and my baseline about 20 hours after was 250ng/dl. If your baseline is that low it doesnt neccesarily mean your not absorbing it.
One purpose of HCG is to bring up the baseline level.

There is probably a little influence from Arimidex on your TotakT levels if any.

So you have drawn blood once at the peak and then 20 hrs latter (as written above).

Blood drawn from differen weeks at different time do not count, all kind of other variables may have been in place.

How do you know when there is a peak for Testogel?

Do you happen to have this type of study for Depo-Testosterone?

 

[nuker]

Nice

 

[ItsHectic]

How do you know when there is a peak for Testogel?

Do you happen to have this type of study for Depo-Testosterone?

I think all the 3 major gel manufacturers have published graphs showing what the peak level is, and they are all 2 hours after application.

There is one for depo-test but I think thats long gone, you would of come across it afew times.

 

[nuker]

wondering: If you don't mind sharing the name of the doctor, I can check to see if he/she is in my insurance plan. PM if you wish. Thanks

 

[JesusReagan]

I have been on Androgel for over a year. A few months ago, I was noticing that Androgel had rapid absorption and short duration of action. I felt edgy shortly after application and felt that I ran low about 4 hours later. My doc at the time wanted to double the dose but admitted that TRT was beyond his expertise.

I switched docs and was put on Testim. With Testim, I don't get the edgy rush I felt with Androgel but the duration is still only about 5 hours.
On Testim I'm cranky and I notice my memory is poor in the morning and later in the day. I only feel good for about 5 hours.

Has anyone had a similar experience where they just don't get the duration they need with the transdermals? I apply the product to my shoulders. Would a different spot be better? Is there anything else I could be doing?

T blood levels are below 180 at around 20 hours after TD application.

I can't seem to find a doc near me with much experience with TRT.

Androgel didn't do well by me, either. Turned me into a woman on her period (which my wife thought was very funny). I got edgy, emotional and weepy, not like me at all. I was switched to a compounded cream, which means you're not putting on nearly as much as Androgel. And, the effect lasts longer (for me, anyway), and I don't have the sides I had with Androgel. PlymouthCity gave me a tip about application. I was rubbing it on my shoulder. He suggested I put it on my forearm, then rub it in with my other forearm. That way, I'm not wasting any by having it on my hands and then having to wash my hands off. Works well.

 

[plymouth city]

There is probably a little influence from Arimidex on your TotakT levels if any.

So you have drawn blood once at the peak and then 20 hrs latter (as written above).

Blood drawn from differen weeks at different time do not count, all kind of other variables may have been in place.

How do you know when there is a peak for Testogel?

Do you happen to have this type of study for Depo-Testosterone?

Arimidex is known to raise FT more so than TT.

TT is not as affected by E levels as FT is.

Getting E levels in desired range raises FT. So adex will work on FT more so than TT.

 

[plymouth city]

Good choice.

Post ZIP of your location, possibly we can do this together.
I am ZIP 07054

JansZ,

You interested in seeing Dr John?

I thought you had happy medium with current Dr.

 

[JanSz]

Arimidex is known to raise FT more so than TT.
TT is not as affected by E levels as FT is.

Getting E levels in desired range raises FT. So adex will work on FT more so than TT.

Do you happen to have a study that confirms this?

I mostly think of Arimidex as a way to lower E2.

 

[nallepuh]

Do you happen to have a study that confirms this?

I mostly think of Arimidex as a way to lower E2.

I thought SHBG bound TT could never convert to e2 or DHT as long as its attached to shbg. If thats true than lowering 5ar and / or aromatize enzymes would definatly have a bigger impact on Free T levels than TT. Total T would only rise as a feedback mechansim of to low DHT or E2 if this indeed is the case. Someone confirm or destroy theory pls

 

[plymouth city]

I thought SHBG bound TT could never convert to e2 or DHT as long as its attached to shbg. If thats true than lowering 5ar and / or aromatize enzymes would definatly have a bigger impact on Free T levels than TT. Total T would only rise as a feedback mechansim of to low DHT or E2 if this indeed is the case. Someone confirm or destroy theory pls

Good job :clap2:

 

[plymouth city]

Do you happen to have a study that confirms this?

I mostly think of Arimidex as a way to lower E2.

It is a way to lower E2.

However, one of the consequences of high E2 is low FT.

E2 doesn't seem to affect TT as much.

It is common to see people with high TT and E2, they usually have very low FT in comparision to TT.

Example is from BW I was just looking at.

TT was 550. E2 was 46 - Before I even looked at FT, I guessed it would be low. Sure enough, FT - 17 (10 - 40)

TT of 550 should have a FT for that range at least above 25.

Check my BW.

TT - 490 (300 - 1200)

Yet FT is only 18 (10 - 40)

Because E2 - 43 (10 - 50)

 

[plymouth city]

JansZ, what was your E2 levels when you had TT of over 1000 when you were on androgel.

I am absolutely positive the BIGGEST reason why TD's don't work for some is NOT thyroid related, but because they convert to more E2. I think E2 is the real culprit. I think the only reason some feel better on shots is becuase of lower E2.

 

[JanSz]

JansZ, what was your E2 levels when you had TT of over 1000 when you were on androgel.

I am absolutely positive the BIGGEST reason why TD's don't work for some is NOT thyroid related, but because they convert to more E2. I think E2 is the real culprit. I think the only reason some feel better on shots is becuase of lower E2.

Androgel 10grams, 2 packets, no Arimidex, 1 pill of DualAction

Short test October 2006 at LabCorp
Total Estrogens------------------------------ ---260 pg/mL (40-115)
estrone, serum------------------------------- ----78 pg/mL (12-72)
Estradiol, sensitive--------------------------- ----27 pg/mL (3-70)
Progesterone---------------------------------- ----1.4 ng/dL (0.3-1.2)
Pregnenolone---------------------------------- ----23 ng/dL (10–200)
Total Testosterone-------------------------- ---932 ng/dL (241-827)
Free Testosterone--------------------------- --36.5 pg/mL (6.6-18.1)
DHT (dihydrotestosterone)--------------- ---226 ng/dL (30-85)
prolactin, serum----------------------------- ----4.2 ng/dL (2.1-17.7)
(TSH)-------------------------- --1.89 uIU/mL (0.350-5.5)
Free (T3)----------------- --2.9 pg/mL (2.3-4.2)
Total T3------------------------------------------ ---104 ng/dL (85-205)
Free T4(direct)-------------------------------- --1.37 ng/dL (0.61-1.76)
DHEA Sulfate------------------------------------- ---369 ng/dL (42-290)
Cortisol (7:20)AM ---------------------------- --24.2 µg/dL (4.3-22.4)
Cortisol (3:20)PM ---------------------------- ----6.9 µg/dL (3.1-16.7)
Hematocrit---------------------------------------- --45.6 % (36-50)

 

[CF10]

Androgel 10grams, 2 packets, no Arimidex, 1 pill of DualAction

Short test October 2006 at LabCorp
Total Estrogens------------------------------ ---260 pg/mL (40-115)
estrone, serum------------------------------- ----78 pg/mL (12-72)
Estradiol, sensitive--------------------------- ----27 pg/mL (3-70)
Progesterone---------------------------------- ----1.4 ng/dL (0.3-1.2)
Pregnenolone---------------------------------- ----23 ng/dL (10–200)
Total Testosterone-------------------------- ---932 ng/dL (241-827)
Free Testosterone--------------------------- --36.5 pg/mL (6.6-18.1)
DHT (dihydrotestosterone)--------------- ---226 ng/dL (30-85)
prolactin, serum----------------------------- ----4.2 ng/dL (2.1-17.7)
(TSH)-------------------------- --1.89 uIU/mL (0.350-5.5)
Free (T3)----------------- --2.9 pg/mL (2.3-4.2)
Total T3------------------------------------------ ---104 ng/dL (85-205)
Free T4(direct)-------------------------------- --1.37 ng/dL (0.61-1.76)
DHEA Sulfate------------------------------------- ---369 ng/dL (42-290)
Cortisol (7:20)AM ---------------------------- --24.2 µg/dL (4.3-22.4)
Cortisol (3:20)PM ---------------------------- ----6.9 µg/dL (3.1-16.7)
Hematocrit---------------------------------------- --45.6 % (36-50)

Quick question...why does LapCorp's range for test only go up to 827 when almost all others I've seen are in the 1000-1200 range for the high end?

 

[plymouth city]

Note that Total estrogens went down with addition of more resveratrol and DIM but E2 was unchanged. (check out JansZ latest BW in his BW thread)

Many were against me when I said E2 can be seperate from E1.

JansZ BW proves I was right all along.

 

[plymouth city]

Quick question...why does LapCorp's range for test only go up to 827 when almost all others I've seen are in the 1000-1200 range for the high end?

Those ranges have been changed as well.

Quest has recently switched over to ranges similar as labcorp

 

[JanSz]

Note that Total estrogens went down with addition of more resveratrol and DIM but E2 was unchanged. (check out JansZ latest BW in his BW thread)

Many were against me when I said E2 can be seperate from E1.

JansZ BW proves I was right all along.

Personally I prefer testing of estrogens the same way the test for testosterone is done.

Because of SHBG differences, we do not put much emphasis on TotalTestosterone but rather look at FreeT.

The new estrogens tests that I have compiled on my list give FreeE2 value, among others.

I have not tested my self this way yet, but wil make attempt at it in September.

This may give a answer why some people feel better at higher while others need lower E2.

 

[plymouth city]

Personally I prefer testing of estrogens the same way the test for testosterone is done.

Because of SHBG differences, we do not put much emphasis on TotalTestosterone but rather look at FreeT.

The new estrogens tests that I have compiled on my list give FreeE2 value, among others.

I have not tested my self this way yet, but wil make attempt at it in September.

This may give a answer why some people feel better at higher while others need lower E2.

I wonder how accurate freeE2 test is, and if it is more valid assumption of the scenario at hand than E2.

LEF likes E2 at 17 - 20, I think they are right on.

I think anyone with an E2 level in that range and solid T levels would feel great regardless of freeE2.

I would like to hear Dr Johns opinion on this matter.

 

[JanSz]

I wonder how accurate freeE2 test is, and if it is more valid assumption of the scenario at hand than E2.

LEF likes E2 at 17 - 20, I think they are right on.

I think anyone with an E2 level in that range and solid T levels would feel great regardless of freeE2.

I would like to hear Dr Johns opinion on this matter.

Interesting question.
There are three differen E2 tests available from Quest.
First, the least desirable.

But then it is the one that we usually like,
then, the third, is this new lattest and greatest.
--------------------------------------------
Speaking of LEF, their range is for the test that is available from LabCorp and they (LEF) also sell scripts for it. This range was published by LEF rather many years ago.
Comparing to Quest test I would say that is the least desirable test.

LabCorp have a better test (the sensitive one) but it can't be purchased via LEF scripts.

 

[plymouth city]

Time shall tell

Never did much research into freeE2 vs E2.

I will get to the bottom of it.

I would like to know what Dr John thinks of it.

Problem with freeE2 is that we have basically zero people to compare data with

 

[nuker]

Going to see Dr. John in a few weeks! Finally, I'll see someone knowledgeable.

 

[JanSz]

Time shall tell

Never did much research into freeE2 vs E2.

I will get to the bottom of it.

I would like to know what Dr John thinks of it.

Problem with freeE2 is that we have basically zero people to compare data with

Wonder how Quest (or Nichols Institute) developed their range for this new test.
They must have some research somewhere.

 

[plymouth city]

Wonder how Quest (or Nichols Institute) developed their range for this new test.
They must have some research somewhere.

Probably a handfull of volunteers(paid) in the area, most completely unknowledgable of whats going on.

Before I ever take stock in freeE I would have to see many with BW list feelings/responses/etc.

Until then I will stick with ultrasensitive from Qst.

 

[cpeil2]

Wonder how Quest (or Nichols Institute) developed their range for this new test.
They must have some research somewhere.

Diagnostic tests go through clinical trails just like therapeutic agents do.

 

[hardasnails1973]

Interesting question.
There are three differen E2 tests available from Quest.
First, the least desirable.

But then it is the one that we usually like,
then, the third, is this new lattest and greatest.
--------------------------------------------
Speaking of LEF, their range is for the test that is available from LabCorp and they (LEF) also sell scripts for it. This range was published by LEF rather many years ago.
Comparing to Quest test I would say that is the least desirable test.

LabCorp have a better test (the sensitive one) but it can't be purchased via LEF scripts.

17-20 e2 is good provided shbg is at optimal range under 30 but if shbg is like 37-40 it could pose a problem same as having low estrogen. I am expereincing it my self !! and it has done a number on my methyation and lipid profile and insulin imblanaces

 

[JanSz]

17-20 e2 is good provided shbg is at optimal range under 30 but if shbg is like 37-40 it could pose a problem same as having low estrogen. I am expereincing it my self !! and it has done a number on my methyation and lipid profile and insulin imblanaces

I am not sure about this (17-20) bussiness.
My blood test 8/26/2005
Total Estrogens=53 (40-114 )
Estradiol E2=38 (21-51)
Total Testosterone=882 (270-970)
DHT=20 (30-85)

I was either on Proscar or possibly on Avodart then, hence low DHT.
I read up on E2(10-30) on LEF and decided to take little of Arimidex to get my E2 down.
Very quickly I lost my erections.
Stopped Arimidex, erections came back.

After stopping, or slowing down on Avodart and without Arimidex my blood test 5/5/2006 shows

TotalE=65
E2=26
TT=1039
DHT=29

I think I am better of with a tad higher E2 values.

Actually I think (I hope) that I will get better information from this new E2 test where also FreeE2 is calculated.

 

[plymouth city]

I am not sure about this (17-20) bussiness.
My blood test 8/26/2005
Total Estrogens=53 (40-114 )
Estradiol E2=38 (21-51)
Total Testosterone=882 (270-970)
DHT=20 (30-85)

I was either on Proscar or possibly on Avodart then, hence low DHT.
I read up on E2(10-30) on LEF and decided to take little of Arimidex to get my E2 down.
Very quickly I lost my erections.
Stopped Arimidex, erections came back.

After stopping, or slowing down on Avodart and without Arimidex my blood test 5/5/2006 shows

TotalE=65
E2=26
TT=1039
DHT=29

I think I am better of with a tad higher E2 values.

Actually I think (I hope) that I will get better information from this new E2 test where also FreeE2 is calculated.

The E2 17 - 20 range is based on calculating BW from healthy males aged 18 - 24. They average out to having TT of 600 - 800 and E2 17 - 25. I have seen the charts/BW before.

Im sure they(young men 18 - 24) have no issues with E2 at 17 - 20

How much adex did you take?

 

[JanSz]

The E2 17 - 20 range is based on calculating BW from healthy males aged 18 - 24. They average out to having TT of 600 - 800 and E2 17 - 25. I have seen the charts/BW before.

Im sure they(young men 18 - 24) have no issues with E2 at 17 - 20

How much adex did you take?

Do not remember exacly, but it was in the area of one and half pill per week, total.
I did some as 1/2 pills and also as 1/4 pills.

There must have been also some variability, as I started with cutting all 28 pills at first into halfs, latter on into 1/4's.
Those cuts were not equal at all.

I hate the cutting part, that is why I now use LiquiDex.

I suppose with Androgel the DHT goes up and E2 probably stays about unchanged.

When I went on T shots now, I took a bet that my e2 will be increasing, so I started on LiquiDex right away.
I am guessing that it was a good bet, so far I feel real good.
Probably in few days I will start putting together what I want on my next blood test.
I will then e-mail it to his nurse.
I will ask for the special test to be written long hand on script paper, so I have a better chance that they actually will go to Nichols Institute San Juan Capistrano.
The balance of tests is a cookie cutter situation, it can be put on form that the usually use or another script, I will let the doc decide.

 

[plymouth city]

The balance of tests is a cookie cutter situation, it can be put on form that the usually use or another script, I will let the doc decide.

Absolutely, agree with you there.

We have to remember that the BW from the healthy males that we shoot for is all we have to go by. HRT is new field.

 

[plymouth city]

One more thing to note JansZ

I noted that you were not on hcG while on Androgel.

Testosterone is testosterone, wether it is from gel or shot.

I am positive that your better QOL on shots over Gel is due to hcG, not shots being better.

Dr John has wrote on this extensively.

hcG protocol - "HCG stabilizes serum levels, opposes testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido. My patients absolutely love it. As time goes on, we are coming to appreciate HCG as a much more powerful--and wonderful--hormone than previously given credit."

I am positive that the numerous LH receptors throughout the body that benefit from hcG use is why you are experiencing better results.

Let us also take another look. Dr John also now does not like his patients using high amounts of exogenous T on hcG day. - "In my previous report I recommended 250IU of HCG twice per week for all TRT patients, taken the day of, along with the day before, the weekly test cyp injection. After looking at countless lab printouts, listening to subjective reports from patients, and learning more about HCG, I am now shifting that regimen forward one day. In other words, my test cyp TRT patients now take their HCG at 250IU two days before, as well as the day immediately previous to, their IM shot. All administer their HCG subcutaneously, and dosage may be adjusted as necessary—but no more than 550IU SC QD.

I made this change after realizing that the previous HCG protocol was boosting serum testosterone levels too much, as the test cyp serum concentrations rise, approaching its peak at roughly the 48-72 hour mark. The original goal of supporting serum androgen levels with HCG had overshot its mark"

You might be exempt from this because you are not injecting the usual 100mg of T on hcg shot day, but a lessor amount.

Let us also take another look at his protocol for exact dosing - " In other words, my test cyp TRT patients now take their HCG at 250IU two days before, as well as the day immediately previous to, their IM shot. All administer their HCG subcutaneously, and dosage may be adjusted as necessary—but no more than 550IU SC QD"

I agree here as well - I think you might be injecting to much hcG. His protocol calls for 500IU of hcG per week. Given he has countless patients to site for as experience, you might want to lower dosage to mimic his protocol.

 

[nuker]

Wondering - How are things going with the Rochester doc? Are you ready to share a name?