Unable to raise T levels

I have been feeling a sense of frustration about the inability to increase my levels on an ongoing basis. I have OCD and my main fear is not being to get an erection. I was quite alarmed when I was diagnose with low T. Since I was diagnosed with low testosterone last year, I have tried shots, AndroGel, and Testim at different times with mixed results. Since October 2003, I have been faithfully applying a full tube of 50 mg Testim everyday with half on each shoulder and upper arm. I spend about two to three minutes each day performing the application. This includes a throughout rubbing in of the gel and squeezing out every last drop from the tube. It has been causing me to worry that I have some other condition that I am not aware of yet<br> <br> I have included some history. Although I am not a doctor, I have made some observations about the test results, symptoms, and my lifestyle. They include:<br> <br> Test results: pre replacement therapy 216. <br> <br> June 6, 2003 - given a 200 mg shot of testosterone in the buttocks.<br> June 20, 2003 - testosterone levels checked, result was 237.<br> June 27, 2003 - given a 300 mg shot of testo. Blood level was checked before hand and the reading was 108. The Dr. commented that he wanted to try a higher dose since it did not seem to take the first time.<br> July 1, 2003 - CAT scan given to check my PITUITARY. Results come back as OK.<br> July 3, 2003 - blood checked again. Level was 1,300.<br> July 15 - level was checked again. Level was 162. Since we did not have this reading at the time of the visit, we started treatment with AndroGel 5%, one tube a day.<br> <br> Question: is it normal to have readings drop that much on shots? Is it possible my body is using too much testosterone and burning it up?<br> <br> July 28 - have level checked. The reading was 254. Talked to Dr bout the low reading and application. I was lightly spreading the gel on my arm since I thought rubbing it in would diminish the effectiveness.<br> August 11 - levels checked again. Reading was 378. Dr felt that was normal but I did not think it was based on my readings.<br> <br> August 29 - meet with with new Dr for the first time. Hr wrote a Rx for Testim one tube per day. I did not start taking right way due to anxiety and having a large amount of Androgel from recent refill.<br> September 18 - have my blood levels checked while still using Androgel. The level was 370 but free was 406. This test was taken in the afternoon. All other tests were taken in the morning.<br> <br> October 6 - start taking Testim for the first time. Did so after feeling AndroGel was not working.<br> November 11 - had a reading of 260. We talked about dosing and how I was placing all on one arm. I started 1/2 on one arm and 1/2 on the other. I also started to watch the absorption into the skin.<br> December 9 - tested with a 460 testo and 520 free. This was considered OK and continued with 50 mg.<br> May 12 - tested with a 302. My doctor is baffled since he feels Testim is far superior to Androgel and no patient has ever needed two tubes.<br> <br> Questions I have:<br> I find myself constantly trying to check to see if i can get an erection by stimulating my penis as part of my OCD fears. Can this checking cause lowered testo levels?<br> How do SSRI drugs affect test and LH levels.<br> Have been trying a low carb diet for about a year with no luck. How can this affect T levels?<br> Should increased T levels improve anxiety and depression issues?<br>

Hi Chris,<br> <br> I'm sorry to say that your case is way too complicated for us to be able to offer you much good information through this forum. You should put all of these questions to your doctor, though.<br> <br> Stress can cause decreased testosterone levels and anxiety, especially performance anxiety, is often enough to prevent a man from having erections. Furthermore, Antidepressants, particularly SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine, are the medicines most frequently implicated in causing sexual dysfunction. You should ask your doctor to do a test of your LH level. If it is low, you might want to consult with an endocrinologist for a more complete diagnosis of the problem.<br> <br> Your diet is probably not the main factor here and although increasing your testosterone level should theoretically improve your mood, your basic depression and anxiety may have to be resolved before you can improve your sexual performance. <br> <br> As I said, your situation is far to complex for us to provide a helpful comment other than to steer you toward an endocrinologist for more extensive diagnostic testing. Good luck.

Thanks for your reply. I realize my case is complicated and I must rely on my doctor.<br> <br> I do have three basic questions:<br> <br> 1. How common is it for people to need two tubes of Testim to get satisfactory readings? It is my understanding from my doctor that Testim is very potent and he has never had a patient need two tubes. I have been finding the opposite based on by web research.<br> <br> 2. What kind of studies have been performed on the advantages of Testim vs. Androgen? I read the package inserts of both products and Androgel seemed to be more effective.<br> <br> 3. What factors have an impact of how well these products are able to raise T level? I do realize each individual is different<br> <br>

1. Two tubes (100 mg) daily is a normal dose based on how low a man's testosterone level is to start.<br> <br> 2. I am looking at a an article that mentions a couple of studies comparing Testim to AndroGel. On page 6 of the following article, the second paragraph indicates that in a head to head study between Testim and AndroGel, "Testim produced<br> 30% higher testosterone levels with a similar safety profile when compared in this head-to-head study."<br> <br> <a href="http://www.medreviews.com/pdfs/articles/RIU_5suppl1_s34.pdf" target="_blank">http://www.medreviews.com/pdfs/articles/RIU_5suppl1_s34.pdf</a><br> <br> 3. I'm sure there are other factors but the only one I am aware of is the presence of certain other drugs in the system (statins, for example).<br>

<br> I have been on three packets of androgel for about 3 months. I started with one, which after a slight T increase, my levels crashed. My doctor moved me to two packets, and my levels rose to just under the normal range. I am 6'2" and 265 pounds and I assume that had something to do with the dosages not being enough. My doctor then adjusted my dosage to three packets of androgel and I finally felt "normal" i.e., not exhausted all of the time. Not really energized, but just not exhausted.<br> <br> I switched insurance providers and pharmacies and they provided "testim" as a generic T-gel. When I tried it I "felt" a significant improvement taking three tubes of Testim versus three packets of Androgel.<br> <br> I use a pair of needle-nose pliers to roll out all of the gel from the tube. They should consider going to packets as it is tough to get all of that gel out using only your fingers.<br> <br> But, getting back to the comparison, I prefer Testim, as it finally made me feel normal and with some level of energy and attendant "good cheer".

Last yesr i was diagnosed with low testosterone. 52 count!!!! My endocrinologist told me that it may have been caused by the vasectomy procedure I had 12 years ago.<br> Three years ago I started to notice depression, low sex drive, irratability, getting fatter no matter what diet I was on. exercised regularly and was losing strength and muscle mass. I had been taking welbutrin and hated it.I had no idea what was wrong. I blamed my wife for almost everything. we got a divorce january. Stopped taking welbutrin. 3 months later I went to my doctor's. She sent me for blood work of which I had no idea want she was looking for. the results came back. I told myself that isn't my blood work. referred to an endocrinologist had more blood work done. He put me on thyroid medication and Testim 1 tube a day. I felt a little better my penis started to behave itself more. my next blood test was only 117. the dr. put me on 2 tubes one on each shoulder. the next test gave me 237. at least this was in the normal range. with no additional medication and doing nothing different my next test was 538!! I feel so much better!!!! I have written an appology to my exwife who has just recently married.<br> My advice with testim is this: remember, you are DEPRESSED!!!! give it time be patient (a good patient)you will do ok it will come around. it has taken me a year to really start to feel right. <br> I also got osteoperosis. I am 49 years old. I take actenel once a week. I was missing about 10% of my bone mass. that has stopped and hopefully it may increase. If I did not take testim and actenel I would not see 65.<br> please feel free to email me with any questions or you just want to talk about it.<br> markkarahalis@hotmail.com

Sounds like we all have about the same problems, except I have no erection problems. I think some of the erection problems are caused by blood problems more than T problems. I have noticed a difference in my erections since I started on androgel. They seem to be fatter more than longer.<br> I also think the quality control is not consistent with my androgel packs. I called the company about this and they assured me that that should not be the case. However, I'm changing to testim when this scrip runs out. Also I have never heard about testim being a generic.

I've tried both products. Didn't care for Testim as it had an odor and was difficult to wash off hands.<br> <br> Achieved seemingly quick results with AndroGel in terms of reduced fatigue, and improvement in libido. Libido has remained high and interest in sex has caused wife problems since her interest is somewhere between what mine used to be and what it is now. Fatigue returned for awhile but has since gone away. Increase in estrodiol (apparently not uncommon with TRT) was seen but it has since lowered again.<br> <br> Readings I have done about products indicate that Testim shows greater increase in Testosterone level than AndroGel but the data is suspect. It was only for a short period of time. There's no concrete information about Testim being superior when it matters - 2 months later, seven months later or even a year.<br> <br> Previous posters have stated various results. Wonder how long they stuck with therapy. It can take six months for full benefits of either product to be seen. I've been on AndroGel over a year and I believe it is helping me. I cannot say I tried Testim that long, but it conceiveably could have done the same. If you try AndroGel, you might consider their new pump. I prefer it over the packets. It's easier to use (and I actually get about 34 days worth of medicine in the two bottles that come with my monthly supply, as opposed to 30 packets.)

Hi,<br> I am following up on my precious post. todays date is November 25, 2006. I am currently taking one tube a day of testim and have continuousl y taken ti for almost 3 years. the past few tests have T levels of 400 to 450. I feel so much better. I have lost weight (I have been working out) My sexual performance has increased, I do not need Viagra anymore. I am getting married in 2 months. It is important to eat correctly. Hemoglobin, calcium and Vitamin D are as important as testosterone for this it seems. I am only too happy to answer any questions or to tell anyone what has happened to me in detail. I wish I had someone to talk to 3 years ago. My doctor is excellent but he does not have this problem and is not aware of all the details especially psychological-hormone related problems. If you are consistant about things, over a period of time things will get better-- at least they did for me. I am now 51 years old.<br> <br> markkarahalis@hotmail.com