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Old 03-17-2008, 09:52 AM   #1
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KevinKiller HB User
Androgel questions

Hi,

I went to my doc when I turned 40 to get "the big checkup". He gave me a bunch of blood tests and when they came back I noticed that my testerone level as 300 in a range of something like 250-1150. I thought it was pretty low and he mentioned something called Androgel and that I should read up on it. Well when reading about it came across a set of 10 questions talking about the symptoms of low-T. I answered yes to all of them except for "Have you lost height" so I went back to the doc and we talked about it and had my blood tested again. It came back with a level of 365 or so. My doc then gave me a prescription for 5mg Androgel and WOW, man have I felt great for the first couple of weeks.

Now I'm worried about all the things I've read about taking this stuff. Things like shutting down your testes and shrinking your testicles ... YIKES!!! I'm going to go back and see my doc at the end of the month and I was wondering what kind of things I should ask him to check in my next blood test or any kinds of medications I might want to take along with the Androgel. I sure don't want to loose my "nuts" taking this stuff.

One problem I've noticed is that when taking androgel I can't get a good nights rest. I wake up in the early morning hours (like 5 am) and can't go back to sleep and the little sleep I do get doesn't seem as restful as it should. Is this a normal side effect? Is there something I can do to fix it, because if I can't sleep I can't live.

Thanks for all your help,

K.

 
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Old 03-17-2008, 10:53 AM   #2
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Re: Androgel questions

with a T level of 350ish your Testicles aren't really working all that well in the first place. you Testicles will shrink on any T therapy. but, i would rather have small testicles then not be able to have sex. mine went from about golf ball to grape size but mr happy works so I'm good.

if you still want to father children you might want to look in to taking HCG this should keep that part of your boys functioning.

I dont take androgel but testim (just a different mixture) and never had any type of sleep effects. Thats somethign you might want to call your doctor on.

 
Old 03-17-2008, 04:33 PM   #3
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Re: Androgel questions

Did you ever wonder how much of testicle shrinkage is myth and how much of it is fact.

I looked at the adverse effects of Androgel, and no where could I find anything that said, testicle shrinkage 100% in all men. That would be a significant thing to mention. It is not in the common side effects or even the uncommon.

I have a hard time finding a study about this, I have looked. The only thing close i have found is weight lifters who use huge doses of steriods and shrink thier gear.

Everyone just assume its a given, well wouldn't it be adverse side effect number one, you would hope so.


Some people take drugs the increase Pitutary gland hormone production, because this is safer and the testicles are then encouraged to produce more testosterone the natural way. say who.

Maybe my Pitutary will swell or some other horrible thing, the truth is we just don't know what each will do in twenty years. You can't see your pitutary every day after a shower like you can with your testicles.

there is no happy alternative..

What we do know is doing something about your low T will make you feel better, and maybe save your life. Low T is a risk factor for heart disease.

I think if you tell twenty men they are taking hormone replacement and thier testicles will shrink, all 20 will swear thier testicles have shrunk even though you only gave the real gel to 25%

can your testicles shrink, yea, is it 100% somehow I dont think so. What if the testicle on average shrinks 1.2% to 5%, would you care?

I asked my doc about this, he said they weren't working right anyway, who's to say they are not shrinking even without the gel. They are not much good to me if they do what they are supposed to, other than astetics.

He had a point.

Last edited by JustDave4now; 03-17-2008 at 04:34 PM.

 
Old 03-17-2008, 05:24 PM   #4
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hayfarmer HB User
Re: Androgel questions

There a lots of inacuracies in the replies so far.

There is no question that your testicles will atrophy while on T replacement. For some men atrophy means smaller testicles (in fact for most men it does). The size change is far more thatn 1 or even 5% for most men. It does vary a lot from man to man. For some men they can shrink down to the size of a pea. For others they may only shrink 5-10%. It makes no difference if you are taking mega doses of T like bodybuilders may use or not. What matters is while on T replacement your pituitary will stop making LH which is what stimulates the testicles to make T. The lack of LH is what causes the atrophy.

How do we know Kevin's testicles do not work? We have no idea if his testicles work or not. All we know is his T is low. Maybe his T is low because his LH is low. Maybe his testicles work just fine but something else is broken? Maybe if we can fix what is broken he will go back to normal without the need for T replacement FOR LIFE.

My assumption on JustDave's comment about taking drugs for stimulating pituitary gland production is he is talking about HCG. HCG does not do anything to the pituitary. HCG is a replacement for the LH the pituitary is not making. HCG is almost identical to LH. I know of no drugs that stiumlate the pituitary. There are drugs like clomid that can be used to trick the hypothalmus into sending more GnRH to the pituitary which will cause the pituitary to make more LH. I think Dave's doctor has a basic misunderstanding of how the HPTA works (Hypothalmus/Pituitary/Testicular Axis). He has used scare tactics to say HCG can have negative effects on the pituitary. There are no studies whatsoever that would indicate this and lots of anecdotal evidence that his claim is false.

My advice to Kevin is to try to find the root cause of your low T. If you can find it you will then know the best course of treatment. Just giving androgel because T is low is really not proper treatment. Low T can often be an indication of a more serious health issue that will remain undiscovered if all you do is treat the symptom. Test for total T, free T, LH, FSH, TSH, prolactin, total estrogen, estradiol and vitaimn D 25OH all in the same test. This must be done at least 1 week after stopping androgel or the results will be skewed by the androgel.

 
Old 03-17-2008, 07:01 PM   #5
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Re: Androgel questions

I agree that the best course of action would be to get the full battery of labs that Hayfarmer mentioned. When I noticed symptoms of Low T and spoke to my doctor about it, originally at the age of 32, my doctor scoffed, but did finally test me. - he only ordered a panel on my T levels. They came back low and he put me on Androgel. Yes, the Androgel made me feel great, but I wanted to know what was causing the low T levels, so that meant seeking out a doctor who would test me for the full thing. I think that it is definitely worth it, as I found out that it was actually high prolactin causing my low T.

As for the Androgel and sleep patterns - it did the same thing to me. I couldn't sleep through the night for about 1 1/2 months, this evened out over time, but throughout the entire time that I was on it, I had horrible night sweats, every night along with hot flashes. And, Yes, it did cause testicular atrophy ( I was on it for a little over 2 years straight) which is one of the reasons I stopped using it. After stopping the Androgel, I did gain some size back, but not all.

My advice would be to definitely get the full testing done to see if they can uncover the underlying cause and go from there.

 
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Old 03-18-2008, 08:02 AM   #6
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Bengie HB User
Re: Androgel questions

Quote:
Originally Posted by hayfarmer View Post
How do we know Kevin's testicles do not work? We have no idea if his testicles work or not. All we know is his T is low. Maybe his T is low because his LH is low. Maybe his testicles work just fine but something else is broken? Maybe if we can fix what is broken he will go back to normal without the need for T replacement FOR LIFE.
in my defense, I view the whole system as not working with my condition. so when I say his testicles aren't working I mean something in the system is not working. wether its a pituitary problem or thyroid or something else causing them not to function. its up to his doctor to determine the root cause and treat it.

 
Old 03-18-2008, 06:25 PM   #7
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jkhh HB User
Re: Androgel questions

I'm at 1+ month on Testim (50 mg) and haven't noticed the negative physical changes that are often referred (to). As Bengie and others have indicated, I would think that the positives far outweight the negatives (at least thus far). I'm much better with the fatigue, anxiety, panic, ED, etc. at this point.

One thing that comes to mind (for cowardly me, at least), is the HCG/T-Cyp approach involves needles OFTEN. I know many of you have discussed this but it would seem a huge advantage to rub gel instead of shots, especially if the gel will work for you. From what I've read, the gels do an effective job at raising levels to normal IN MOST MEN. I realize there are those (such as Hayfarmer) who could not achieve normal/adequate levels on gel but I certainly think it's worth a try. As JustDave indicates, I would imagine there are many (or most) gel users who do well with it without these adverse side effects. Plus, there are a great deal of studies involviing the gels too so one can't really say it's experimental.

Kevin, as to the sleep issue, did your doctor test your thyroid? Ofen, sleep issues are related to thyroid (was for me). Once I started synthroid, I was able to rest. Actually, seems like I rest better now with the Testim. Good luck.

Last edited by jkhh; 03-18-2008 at 06:33 PM. Reason: omission

 
Old 03-18-2008, 07:28 PM   #8
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KevinKiller HB User
Re: Androgel questions

Ok,

Thanks for all the great responses. I got a hold of my medical records and here are some numbers.

The first test was done on 1/25 and included:

TSH, 3rd generation: 3.11 range: 0.40 - 4.50 mIU/L
Testererone, Total: 300 range: 241-827 ng/dL

The second test was done on 2/15 and included:

Follicle Stim Hormone: 3.7 range (adult males): 1.5-14.0 MIU/ML
Luteinizing Hormone: 3.0 range (male): 1.0 - 9.0 MIU/ML
Testererone: 383 range (male): 241-827 NG/DL

I think that the TSH is short for Thyroid-stimulating Hormone and it is normal.

I don't know how many of these things match up with hayfarmer's list of:
total T, free T, LH, FSH, TSH, prolactin, total estrogen, estradiol and vitaimn D 25OH

So my big question is: Why doesn't my doctor know enough to do this stuff? What kind of questions should I ask any potential new doctors to be sure they know what they're doing? How can I be sure that the doctor knows how to interpret these test results and even more important: pick the right treatment for anything that might be wrong because right now who knows if Androgel is the right treatment for me? And it sure is a pretty serious medication to be fooling around with if not!

I can be sure to not take any androgel for 7 days before seeing a new doctor (if I can find one that know's what he's doing). I had no idea that this Androgel thing was a life time commitment or that it would shut down my natural testererone and cause my nuts to shrink! I should have been informed I think.

Thanks again,

K.

 
Old 03-18-2008, 07:50 PM   #9
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KevinKiller HB User
Re: Androgel questions

Ok,

I have the blood-draw paper work and I've found Estradoil, FSH, LH, Prolactin, TSH, and Testosterone boxes but I can't find Free T, total estrogen, or vitaimn D 25OH boxes.

The only box my dr. checked with the Testosterone. Do you think he'd get mad if I checked the Estradoil, FSH, LH, Prolactin, and TSH boxes as well? Do I have to go see him to get the other stuff checked? What should I do if he doesn't want to order all those tests? I mean, is it a reasonable thing to ask for all those tests? I've got pretty good Blue Cross/Blue Shield PPO health insurance so hopefully money won't be a big factor like it would with HMO plans where everything is subject to insurance company review.

Thanks again,

K.

 
Old 03-18-2008, 08:46 PM   #10
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hayfarmer HB User
Re: Androgel questions

Bengie, not picking on you but Kevins testicles are possibly at stake and it is important to make sure he is informed and then let him make up his own mind. The way I read your post it sounded like he should not worry about his testicles shrinking because they don't work anway which may not be true.

Kevin, you have run into the problem many of us do. How to find a doctor that knows how to treat this. Unfortunately it is hard to do. Most do not know how to treat it amazingly. I can give you names of doctors in PA , MI and CA that do but if you're not willing to travel it won't do you any good.

I would call the doctors office and ask for permission to run the other tests if it were me. You can run tests at your own expense thru labs you can find on the internet but insurance will not pay if a doctor does not order the test. Hopefully your doctor would not care if you do want these other tests. Honestly I don't know why he would care. If he does not you should be able to check the boxes yourself. If you do it without his permission about the worst that could happen is he gets mad at you. He could tell the insurance he did not order the tests but I doubt any doctor would do that.

Based on the numberes you posted you seem to have secondary hypogonadism which is where the pituitary is not sending enough LH to stimulate the testicles to make T. With a total T of 300's your LH should be high to try to get T higher but it's not. So the key would be to try to determine why LH is not high. If you can't trave then search the internet for doctors in your area that may specialize in this. Before you make an appointment ask if the doctor specializes in treatment of male hypogonadism. Possibly try a reproductive endocrinologist first but there is no guarantee not matter what doctor you try that he will know this subject. Your T is only slightly low so you may be able to find a way to resolve this without T replacement. T replacement is usually for life and it is not perfect but I do agree with the others that it is better than doing nothing. You can not live with low T. It will lead to too many complications beyond the sexual problems.

Edit: While your TSH is in range it is slightly high. You should keep an eye on it....you may end up with hypothyroidism too eventually.

Last edited by hayfarmer; 03-18-2008 at 08:48 PM.

 
Old 03-19-2008, 05:33 AM   #11
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jkhh HB User
Re: Androgel questions

On the part about you checking for additional tests, you don't want to do this because for your insurance to pay for the test, you must have the correct cooresponding diagnosis.

As to the thyroid, Hayfarmer is correct. I would have an endo physically examine my thyroid because you can still have a nodule (I do) without being considered hypo or hyper thyroid. Most important, a nodule can cause the symptoms of hypo or hyper such as sleep interuption, depression, anxiety, panic, etc. Plus, if you have a thyroid issue, replacing t can enhance your thyroid issue if you don't substitute thyroid replacement. If you end up at an endo for your t, hopefully they would do some more thorough lab testing on your thyroid (such as FT4, FT3) and physically examine your thyroid (including the doctor physically touching your thyroid and possibly an ultrasound-if the physical warranted it).

On the lifetime commitment, you need to understand your lab values are much like the rest of us here (low or low normal LH, FSH, low T=2ndary Hypogonadism) and with very few exceptions, it's a lifetime issue regardless of whether you're taking shots, using gels, pellets, etc. I'm aware of a few on here who have successfullly restarted their t production to a level that is normal or above. The problem is can you find a doctor to take an alternate approach to conventional treatment without suffering a financial hardship due to travel, non-insurance coverage, etc. As Hayfarmer has pointed out, the most important thing is to understand the underlying problems of not dealing with it (if you haven't already, read the ook-The Testosterone Syndrome by Dr. Shippen).

Last edited by jkhh; 03-19-2008 at 05:35 AM. Reason: omission

 
Old 03-19-2008, 09:31 AM   #12
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Bengie HB User
Re: Androgel questions

Quote:
Originally Posted by hayfarmer View Post
Bengie, not picking on you but Kevins testicles are possibly at stake and it is important to make sure he is informed and then let him make up his own mind. The way I read your post it sounded like he should not worry about his testicles shrinking because they don't work anway which may not be true.
I agree Hayfarmer. I'll be more clear in my responses from now on.

 
Old 03-31-2008, 07:58 AM   #13
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hrt81 HB User
Re: Androgel questions

I have been on androgel now for two weeks and have noticed positive changes relative to my body strength, energy and better moods. However, I have noticed relatively no changes regarding libido nor strength of erections. For those of you that have taken androgel I have a couple of questions....

1) I am currently taking 5 mg a day. When you increased your dosage from 5 mg to 10 mg a day, did you notice a major difference in libido and/or erection strength?

2) Am I being premature here? Should I be waiting a couple more weeks to realistically expect any major change in libido and/or erection strength?

As you can tell, this issue is really consuming my thoughts right now with being only 27 years old and having libido and ed issues. While I don't doubt that this issue will be corrected for me, it is really frustrating right now.

 
Old 04-16-2008, 06:09 AM   #14
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dbo1234 HB User
Re: Androgel questions

Quote:
Originally Posted by KevinKiller View Post
Hi,

I went to my doc when I turned 40 to get "the big checkup". He gave me a bunch of blood tests and when they came back I noticed that my testerone level as 300 in a range of something like 250-1150. I thought it was pretty low and he mentioned something called Androgel and that I should read up on it. Well when reading about it came across a set of 10 questions talking about the symptoms of low-T. I answered yes to all of them except for "Have you lost height" so I went back to the doc and we talked about it and had my blood tested again. It came back with a level of 365 or so. My doc then gave me a prescription for 5mg Androgel and WOW, man have I felt great for the first couple of weeks.

Now I'm worried about all the things I've read about taking this stuff. Things like shutting down your testes and shrinking your testicles ... YIKES!!! I'm going to go back and see my doc at the end of the month and I was wondering what kind of things I should ask him to check in my next blood test or any kinds of medications I might want to take along with the Androgel. I sure don't want to loose my "nuts" taking this stuff.

One problem I've noticed is that when taking androgel I can't get a good nights rest. I wake up in the early morning hours (like 5 am) and can't go back to sleep and the little sleep I do get doesn't seem as restful as it should. Is this a normal side effect? Is there something I can do to fix it, because if I can't sleep I can't live.

Thanks for all your help,

K.
I have been on twice the dose for 2 years now. It does indeed screw up your sleep, but I have notice no other negative side effects. I think the postive far outweighs the negative.

 
Old 04-16-2008, 10:54 AM   #15
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hrt81 HB User
Re: Androgel questions

How much dosage of androgel are you currently on? Was your experience any similar to what I have typed below? How long before you noticed success relative to ed and libido?

 
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