dg_moore wrote:OK, after a month on Androderm I had my T tested again. Before starting on Androderm my level was reported at 238. After a month the level is now reported at 130 (
). I am not noticing much change in how I feel (energy, mood, libido), but I'm guessing that one of these readings is incorrect. I've contacted my doc to see what he wants to do - presumably re-test.
First off, I'm not a medical professional. What I'm relating is just what I read.
There is an outfit in Oregon, zrtlab.com, that provides an alternative explanation of what might be happening to you when you take exogenous transdermal T, and your venous blood levels of T drop. It is that venous blood levels of T do not correctly measure the levels of T that your body is taking in. The drop in venous T might be meaningless, or even evidence that you're overdosing exogenous T. Let me say right off, that this is not totally mainstream accepted medical consensus. I've consulted two docs about my T, and one totally believes zrt and believes you should measure T in saliva or blood spot as zrt recommends. And another, a professor at the local medical school, who believes this is all bunk.
zrt claims that venous blood levels of T correctly measure what your T levels are if you're not doing TRT, or if you're doing injections or pellets, its still correct. But they claim when applying transdermal T (gels, creams, etc absorbed by the skin) your body is actually absorbing much more T than venous blood levels show, and that if you measure saliva or "blood spot", you will get more correct readings.
Here's their explanation of why your venous blood levels of T might drop, at least as I understand it. You apply the transdermal T. Your body absorbs it. Causes your LH to drop since your body detects the higher T. LH is produced by the pituitary and stimulates your testes to produce T, and since you now have a lot of T, your body is signaled to stop producing so much. Natural T levels drop. Venous blood draw measures the drop in natural T but not the transdermally absorbed T.
How to know if this is what's happening? Measure LH before TRT and while on TRT and see what happens. Your LH should be very high with true low T (if its not that means your low T is "secondary hypogonadism" and you should be trying to stimulate your testes to produce more T, by taking clomid or exongenous HCG which contains LH, not taking expogenous T). If your LH drops to normal or low once you start transdermal T, that is a signal your body is absorbing the T. Similarly your body converts (aromatizes) T to estrogen (E2). You might expect E2 levels to rise too if you are really absorbing T. And, of course what zrt wants you to do is order blood spot or saliva tests from them. They would show much higher levels of T in your body than the venous blood test.
OTOH, if your T drops and your LH stays sky high, or increases, and your E2 doesn't go up, and your blood spot and saliva tests don't show a rise in T, then something else is going on.
I wouldn't go to a doc who doesn't at least measure LH and E2, before and during TRT. Even with injections or pellets you should also be measuring E2. If your LH drops low, your body does not produce T, and your testes shrink, and eventually you loose the ability for them to produce T or sperm. Too much E2 not only makes you feel bad, but most medical authorities believe it increases your risk or heart attack, stroke, and other bad things. zrt blood spot and saliva tests, though, are not really mainstream medicine at this point.