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Author Topic: Introduction, Axiron Fail and questions about what to expect  (Read 16238 times)

TheWife

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Introduction, Axiron Fail and questions about what to expect
« on: March 21, 2013, 02:55:10 pm »
Hi all!
I am relatively new here and I am hoping not to get the Slingshot to Mars by the "He-man Woman Haters Club"

I am one of those faithful wives who has been suffering with Low T along with my husband for a long time now.

We have been together for 22 years and married for 18 years (as of yesterday) We know his T levels started dropping about 2 years into the relationship but we are not sure why. It took us until July of 2011 to even convince a doctor to test for that at all.

That test came back around 230 and we were referred to an Endo.

They couldn't get us in to see him for 3 more months. He ordered a lot of bloodwork to try and determine if it was primary or secondary We waited 3 more months to see him to get these results. At this appointment he stated that it was primary hypogonadism. But while being on the low side at 209 he said hubby was still within the normal range.
I argued with him at that point because I had never seen any scale where this was in the normal range. I cried and pleaded with him to at least let us try HRT.

He finally gave in and said we could do a 6 month trial of Axiron and sent us on our way. We were so excited because we thought it would make a difference. It even seemed to make a little bit of difference for the first few weeks.

When we saw the Doc in six months he did another total T test and said the number was 4-something (this one I cant remember) but around 450. To hell with the fact that we had no symptom relief. Wrote another script for Axiron and sent us on our way.

FFW to now. We have moved to a different state and needed a new doctor. We found a Urologist in the next state and drove 150 miles to see him last Friday. He seemed interested in getting to the heart of the issue. I will post test results below. But he encouraged us to see one of his colleagues and a good friend of his who is actually only about 20 minutes from us. We have an appointment with him for this Friday.

The doc in the next state called with the lab results and said we definitely need to change the delivery method right away and wanted to see us back this week if we were not able to get in with the doctor here. He would recommend  Testopel.

Here are the results of the most recent tests (on axiron 2 accuations per day)

testosterone, serum                     248       348-1197    ng/dL       

sex horm binding glob, serum       16.7       16.5-55.9    nmol/L

estradiol                                       23.3       7.6-42.6    pg/mL

prostate specific ag, serum       0.8               0.0-4.0    ng/mL

hematocrit                               42.5       37.5-51.0    %

hemoglobin                               14.3       12.6-17.7

My questions are should we start off with testopel since it is a straight dose and cant be adjusted until the next round of implants or would it be better to go with injections until we find the right dosage?

I know the E2 is normal right now but isn't it already too high in relation to the Testosterone?

I don't really know much about the SHBG but I did notice it is on the very low side of the scale. Is that good or bad?

Also what might be a good starting dose to look for with the testopel or the injections?

Thanks in advance,
The Wife

PS My hat is off to MS. Anonymous11. You go girl!!!
 

PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #1 on: March 21, 2013, 03:49:25 pm »
Hi all!
I am relatively new here and I am hoping not to get the Slingshot to Mars by the "He-man Woman Haters Club"


If anyone posts anything toxic, I'll delete it.  Just give me a few hours as I'm not always on the forum of course...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Introduction, Axiron Fail and questions about what to expect
« Reply #1 on: March 21, 2013, 03:49:25 pm »


PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #2 on: March 21, 2013, 04:11:42 pm »
Hi all!
I am relatively new here and I am hoping not to get the Slingshot to Mars by the "He-man Woman Haters Club"

I am one of those faithful wives who has been suffering with Low T along with my husband for a long time now.

We have been together for 22 years and married for 18 years (as of yesterday) We know his T levels started dropping about 2 years into the relationship but we are not sure why. It took us until July of 2011 to even convince a doctor to test for that at all.

That test came back around 230 and we were referred to an Endo.

They couldn't get us in to see him for 3 more months. He ordered a lot of bloodwork to try and determine if it was primary or secondary We waited 3 more months to see him to get these results. At this appointment he stated that it was primary hypogonadism. But while being on the low side at 209 he said hubby was still within the normal range.
I argued with him at that point because I had never seen any scale where this was in the normal range. I cried and pleaded with him to at least let us try HRT.

He finally gave in and said we could do a 6 month trial of Axiron and sent us on our way. We were so excited because we thought it would make a difference. It even seemed to make a little bit of difference for the first few weeks.

When we saw the Doc in six months he did another total T test and said the number was 4-something (this one I cant remember) but around 450. To hell with the fact that we had no symptom relief. Wrote another script for Axiron and sent us on our way.

FFW to now. We have moved to a different state and needed a new doctor. We found a Urologist in the next state and drove 150 miles to see him last Friday. He seemed interested in getting to the heart of the issue. I will post test results below. But he encouraged us to see one of his colleagues and a good friend of his who is actually only about 20 minutes from us. We have an appointment with him for this Friday.

The doc in the next state called with the lab results and said we definitely need to change the delivery method right away and wanted to see us back this week if we were not able to get in with the doctor here. He would recommend  Testopel.

Here are the results of the most recent tests (on axiron 2 accuations per day)

testosterone, serum                     248       348-1197    ng/dL       

sex horm binding glob, serum       16.7       16.5-55.9    nmol/L

estradiol                                       23.3       7.6-42.6    pg/mL

prostate specific ag, serum       0.8               0.0-4.0    ng/mL

hematocrit                               42.5       37.5-51.0    %

hemoglobin                               14.3       12.6-17.7

My questions are should we start off with testopel since it is a straight dose and cant be adjusted until the next round of implants or would it be better to go with injections until we find the right dosage?

I know the E2 is normal right now but isn't it already too high in relation to the Testosterone?

I don't really know much about the SHBG but I did notice it is on the very low side of the scale. Is that good or bad?

Also what might be a good starting dose to look for with the testopel or the injections?

Thanks in advance,
The Wife

PS My hat is off to MS. Anonymous11. You go girl!!!

You asked a lot of q's, which is great btw, but I'll probably only answer about half of them so hit me up again for what I have left out. 

First of all, the Axiron is just not working.  Sometimes it works; sometime it doesn't - that's just the way it is with the topicals.  If he really wants to stick with a topical, ask your doc about compounding:

http://www.peaktestosterone.com/Compounding_Testosterone

Pellets are a fine choice.  Urologists have to do this as far as I know.  They are very convenient in the sense that you just get pellets once every 3 or so months.  You start out pretty high and dip down about 50% I believe after about 3 months.  That's a rough #:  talk to your doc for the exact figures.

I've got some info on it that you can read if you'd like:

http://www.peaktestosterone.com/Testosterone_Pellets

This guy here, LowerT51, loved pellets and was our Testopel spokesperson for awhile:

http://www.peaktestosterone.com/Interview_Testopel_Testosterone_Pellets

https://www.peaktestosterone.com/forum/index.php?topic=478.0

I say that tongue-in-cheek as he was just a regular Joe like all of us here.  However, I point out his story because the procedure for pellets can be a little painful and, from what I've heard, it depends somewhat on your body weight.  If you're thin, it's going to hurt a little more possibly.  I bring this up, because LowerT51 lost quite a bit of weight and had the procedure again and told me that it was quite painful this time, verifying what I had heard.  He was actually thinking of going to injections or some other delivery method.

Injections are another great alternative and I want to bring up one choice that you are probably unaware of:  Nebido.  It is an long-lasting ester that require an injection only every 6 weeks or 2 months or so, so it also is very convenient and much less painful from what I have heard.

One last thing:  pellets are a fine choice, but realize that your urologist has a vested interest more than likely.  Why?  It is an actual procedure for which he gets pretty big reimbursement from the insurance company if he can get approval.  Some docs actually use private companies to talk with the insurance companies and see if they can get reimbursement as it is new and higher dollar, etc.

Imo getting your estradiol regularly monitored and managed is very important.  This can make or break the success of the HRT for many men.

NOTE:  I can't advise you whether or not to go on HRT, that's between you guys and your physician of course.  But use the above as discussion points with him/her so you can decide what is best for your situation.

Gotta run...
« Last Edit: March 21, 2013, 04:24:04 pm by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

TheWife

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #3 on: March 21, 2013, 04:32:35 pm »
Thanks for the fast reply.
We asked the first Endo we saw if we could do the pellets and he said he would prescribe them but not do the implant. We have a friend who is a surgeon that said he would do the actual procedure but he would have to study up about it because he hadn't done it before.

Although we trust him completely we weren't comfortable with that since we didn't feel the Endo was monitoring things properly anyway.

I have seen Nebido mentioned here but wasn't sure what it was so I will have to look it up. What is the half life? Does it have the sharp rise and then decrease like the other injections.

I know weekly seems to be a good injection schedule for say test-c, would it be better to have the Nebido at 6 weeks or 2 months and can you self inject it like the others if the doctor allows it?

Thank you for all of the information your website provides.

Peak Testosterone Forum

Re: Introduction, Axiron Fail and questions about what to expect
« Reply #3 on: March 21, 2013, 04:32:35 pm »


PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #4 on: March 21, 2013, 04:44:53 pm »
Thanks for the fast reply.
We asked the first Endo we saw if we could do the pellets and he said he would prescribe them but not do the implant. We have a friend who is a surgeon that said he would do the actual procedure but he would have to study up about it because he hadn't done it before.

Although we trust him completely we weren't comfortable with that since we didn't feel the Endo was monitoring things properly anyway.

I have seen Nebido mentioned here but wasn't sure what it was so I will have to look it up. What is the half life? Does it have the sharp rise and then decrease like the other injections.

I know weekly seems to be a good injection schedule for say test-c, would it be better to have the Nebido at 6 weeks or 2 months and can you self inject it like the others if the doctor allows it?

Thank you for all of the information your website provides.
Whoa.  They've got youtube videos of the procedure.  I don't think you want to be his first patient, but that's just me!  Btw, infection can be an issue as well as the pellets falling out.  Sometimes they will give you an antibiotic a day or two before as you don't want cellulitis!

I would think estradiol would be harder to manage on Nebido and the pellets:  you really need a doc who knows the curves of these products really well.

Nebido is new here in the US and so I don't know if you can find a doc who will let you self-inject.

Nebido, from what I have read, is just the old testosterone undecanoate which has a half life of about 18-21 days.  Obviously, this would leave you hypogonadal for weeks on a 6 week or greater schedule.  I think the trick is that they suspend it in castor oil which makes it slower-releasing.  You'd have to call the mfg to find out though.  Let us know if you get an answer on that.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Ken

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #5 on: March 21, 2013, 05:09:35 pm »
Wife,

I had my own bad experience with Axiron to include armpit rash! I am now on weekly injections that my wife and I administer ourselves.  It's really not that bad, and now that I've been doing them for a few weeks I feel pretty leveled out without highs and lows. Anyway here is the thread that I started regarding the Axiron Failure and subsequent injections if you're interested:

https://www.peaktestosterone.com/forum/index.php?topic=997.msg9187#msg9187

If you have any questions regarding injections such as needle sizes (length and gauge) or injection sites I can answer those for you too as I just dialed in what I believe is the best process, for me at least.

Good Luck
Age: 52
Wt: 210lb
Ht: 6'1"
BF% 12.5

TheWife

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #6 on: March 21, 2013, 05:18:27 pm »
  I don't think you want to be his first patient, but that's just me!


Yes I'm glad we didn't go that route.

I still think that the plain old injectable Test-c would be the best route for us.

What is a good starting dose per week? I intend to insist on weekly injections if we choose to go that route?

and isn't the ratio of test/e2 pretty high even at this point?

Ken, thanks I will go an read your post
I hadn't even thought of needle size....

PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #7 on: March 21, 2013, 05:37:50 pm »
  I don't think you want to be his first patient, but that's just me!


Yes I'm glad we didn't go that route.

I still think that the plain old injectable Test-c would be the best route for us.

What is a good starting dose per week? I intend to insist on weekly injections if we choose to go that route?

and isn't the ratio of test/e2 pretty high even at this point?

Ken, thanks I will go an read your post
I hadn't even thought of needle size....

120 - 150 mg weekly is pretty common.

Yes, E2 will likely go high for the first six to nine months and so you'll want to be monitored.  Do a search on Arimidex in the search above on this forum and you'll get a lot of examples of men using low dose Arimidex to manage this.  A big percentage of men can get off the Arimidex after 6-9 months.  In addition, the testosterone will help your husband manage his weight better and hopefully even lose some weight will lessen his need for Arimidex (if you go that route) even further.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Ken

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #8 on: March 21, 2013, 05:42:39 pm »
The ratio appears to be ~ 10:1 which is not ideal.  I believe Peak will state that closer to 20:1 is better if possible and that anti-aging clinics aim for even higher ratios.

As far as starting dose, I started at 100mg/week which is 1/2CC of 200mg/CC.  This brought me up from 310 to 460.  At one month my doc upped me to 150mg/week and I get my next blood tests in about 4 more weeks.  I also started 1/2mg twice per week of Arimidex to lower my estrodial and improve the T/E2 ratio.  At one month my ratio was about 14:1 because even though my total T went up, so did my E2.  Arimidex basically blocks the the process that allows fat cells to convert T to E. The thinking is that the Arimidex will only be necessary for 6 to 9 months until everything balances and levels to stable points. 

I don't think I posted my latest "dialed in" specs for needles and such, so perhaps I will update a separate thread that I started on that topic a little later today and then refer you that when it's ready.

Ken
Age: 52
Wt: 210lb
Ht: 6'1"
BF% 12.5

PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #9 on: March 21, 2013, 05:49:51 pm »
The ratio appears to be ~ 10:1 which is not ideal.  I believe Peak will state that closer to 20:1 is better if possible and that anti-aging clinics aim for even higher ratios.


I've got my opinion of course but can't really give you a formula here.  I will say that the antiaging and HRT clinics try to get their guys in the 650 -950 range for HRT and estradiol in the 20-30 range.  So the average ratio in this scenario would be somewhere around 25. 

This is similar to what is being done with anonymous, by the way, and can have spectacular results, but certainly not always of course.  Speaking of that, it's incredibly important to have a well visit in my opinion and make sure there are no basic underlying issues.

Also, testosterone administered like the above can have dramatic results on insulin and prediabetes:

http://www.peaktestosterone.com/testosterone_diabetes

http://www.peaktestosterone.com/testosterone_insulin

For the typical middle-aged, struggling male, this can make a huge difference in his health for many reasons...
« Last Edit: March 21, 2013, 05:52:53 pm by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

TheWife

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #10 on: March 21, 2013, 06:19:37 pm »
Ken, Thank you for sharing your experience and what works well for you. I know everyone is different but we weren't really very prepared to be proactive when he first started HRT a little over a year ago. So it helps to have an idea of what others are having success with.

PeakT
Thank you for all of the information you have taken the time to compile and post on your website and the forum. I have read it all and reread a lot of it but it is a lot to absorb.

I just bought the book you mentioned on the other thread and will let you know if its a good read.

He has had a recent visit with his GP and he had general blood work done at that time. He does have high blood pressure which is well controlled with medicine.

This has been an issue since about the same time as we started noticing the decline in libido and depression 20 years ago. He was also diagnosed with obstructive sleep apnea around that time and used a cpap machine for years. But has had 3 sleep studies since then that all determined he no longer has sleep apnea. I think his weight has a big effect on the sleep apnea. When he is heavier I can tell a difference in how he breaths(or stops breathing) when he sleeps and when he is thinner he doesn't seem to stop breathing at night.
I am aware that this needs to be monitored while on HRT but I suspect that when his testosterone levels come up he will lose weight and this won't be a problem.

Do you have any thoughts on whether or not having a vasectomy can cause low T? I have seen this mentioned but can't find any real studies on this. Incidentally  all of this stuff started to go awry about 10 or 11 months after he had his vasectomy. And the doctors we have seen have all said the type of hypogonadism he has  is likely related to a testicular injury but we can't (he can't) recall one.

LowerT51

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #11 on: March 22, 2013, 01:48:53 am »
i like the pellets because they boost my t levels to a point where the difference is remarkable for several weeks  have been on them for two years.  Also like them as i can forget about t stuff for at least three months between insertions  i started jogging regularly about 9 months ago and have lost about 10 lbs especially in thighs and butt. the fat cushion is smaller now so that last insertion about 4 weeks ago smarted for about a week .  i would consider injections but would need to find a doc no more than 10 minutes from home as now we are talking every 10 days versus three months . 

PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #12 on: March 22, 2013, 02:50:47 am »

Do you have any thoughts on whether or not having a vasectomy can cause low T? I have seen this mentioned but can't find any real studies on this. Incidentally  all of this stuff started to go awry about 10 or 11 months after he had his vasectomy. And the doctors we have seen have all said the type of hypogonadism he has  is likely related to a testicular injury but we can't (he can't) recall one.

The studies are mixed on the subject as you can check out here:

http://www.peaktestosterone.com/Vasectomy
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Ken

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #13 on: March 22, 2013, 04:10:39 pm »
LowerT51,

Perhaps I misunderstood your post.  Are you hesitant to go with injections because you would have to travel to your dr office too often for shots?  Unless you just dont want to either self inject or have your wife (or somebody else) inject for you, you really shouldn't have to go to his office for this.  My doctor was totally fine with my wife and I doing the injections. 

Just a thought.

Regards.
Age: 52
Wt: 210lb
Ht: 6'1"
BF% 12.5

PeakT

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Re: Introduction, Axiron Fail and questions about what to expect
« Reply #14 on: March 22, 2013, 06:39:12 pm »
LowerT51,

Perhaps I misunderstood your post.  Are you hesitant to go with injections because you would have to travel to your dr office too often for shots?  Unless you just dont want to either self inject or have your wife (or somebody else) inject for you, you really shouldn't have to go to his office for this.  My doctor was totally fine with my wife and I doing the injections. 

Just a thought.

Regards.

A lot of docs won't allow it, though, because it is a controlled substance and I'm sure they are worried about abuse and/or lawsuits.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Introduction, Axiron Fail and questions about what to expect
« Reply #14 on: March 22, 2013, 06:39:12 pm »