In January I had my test levels checked because I was experiencing the same similar symptoms as others on this board. Most noted ED, lack of concentration and mind fog.

My result from my primary came back as 305 for serum test and 8.3 for free test. Nothing else was checked. He gave me a sample of Androgel (5 grams) and sent me on my way. I lathered up and morning wood came back and so forth. Two weeks later things began to taper off....same as others had reported.

In February my levels were rechecked and serum test came back as 714 and free test 20.3. Other test noted that were not performed the first time but this time around were LH (1.6) and FSH (1.9) along with PSA counts. My understanding, if I'm correct, is that Androgel will lower these two hormones?
If true I will not be able to get a true assessment on where the problem may actually lie.

I immediately switched my primary to one who is more knowledgeable in this subject area. He advised me right off to see an Endo (March 29), along with an MRI and quit the Androgel and get a full hormone check.

I know it would be difficult to evaluate my situation with little information I provided but this is all that I have.

After thinking about it I noticed symptoms could have started about five years ago, concerning feeling tired often. Erections were very strong during that time until about six months ago when I noticed a few times something was going on but nothing extreme. I thought maybe I was getting older (41) and not as interested. I'm in excellent shape, muscular build and about 12 percent body fat and I get compliments that I look in my mid to early thirties.

I failed to mentioned about a year ago I requested that my test levels be checked and the result then was 520 for serum test. A big difference from my results in January. I know test levels can fluctuate as the day goes on but a drop of more than 200 in a little over a year has me concerned. Sorry that is all I remember.

I been reading this section of the board for a couple weeks and it has been extremely helpful. I knew nothing coming in but reading post from "HayFarmer" and others has been a big asset.

You're on the right track to get off the androgel and run tests for all the hormones. Being off it a week should do before you take labs. You are right that the androgel will skew the LH and FSH tests so they are pretty useless while on it.

Your level at the low 300's is not too awful but it is too low. You need to try to determine the root problem and that is what your doc is trying to do now. Getting the MRI (I assume of the pituitary) is a good start too. Make sure you have the following checked at a minimum after being off androgel for at least 1 week: total T, free T, LH, FSH, TSH, prolactin, estradiol, total estrogen. It is helpful to know SHBG also. If you turn out to have secondary hypogonadism (meaning T is low while LH is normal or low) then you should also have iron levels (iron, ferritin, TIBC, saturation%) checked to rule out hemochromatosis and a vitamin D 25-OH test.

At your age you probably have secondary hypogonadism. Primary is where the testicles stop working (not likely at 41 but possible). Secondary is where the pituitary or hypothalmus in the brain are not sending the signals to the testicles to tell them to make enough T. At 41 I would resist the doc pushing you into T replacement alone unless it is supplemented with HCG. HCG (human chorionic gonadotropin) is almost identical to LH and will keep your testicles working. Otherwise they will stop working and shrink and you will be more or less sterile also.

You might also want to run a clomid test in which after all the androgel is out of your system you take clomid (I think I took 50 mg / day) for a week and then test to see if LH went up. If so, clomid may work for you or it may be that your estrogen is too high and you can do something to bring that down to solve the problem. Estrogen is very similiar molecularly to T and can trick the hypothalmus into thinking its T. The end result of that is your body makes less T in that case which is one reason clomid may work. Clomid can block estrogen from attaching to the hypothalmus receptors meant for T.

Make sure you keep copies of all your labwork in case you ever change docs, or just for your own use. If you post your numbers I'll be happy to comment. Oh, I forgot, yes T levels fluctuate all the time even within a single day but going from 520 down to 300 seems a little extreme to me. Still your doctor should have run a second test before even starting androgel or any treatment if for no other reason to make sure the lab didnt make a mistake. You don't want to mess with your hormones if you don't have to.