Axiron Failure

[Ken]

Hi,

New here.

I am a 50yo male and began Axiron 30 days ago.  It did take 3 doctors to get prescribed. Third was the charm.  My initial total and free levels were 374 (range: 250 - 1100, quest) and 63.4 (range: 35.0 - 155.0, quest). I am a pretty fit guy at about 12% body fat, but for the last year or two I have had decreasing energy, a complete drop off in libido, and decline in general feeling of wellness.  Also body fat % has been climbing no matter what I do with diet or in the gym. My GP ordered the first blood work which are the numbers above. He said I'm in the normal range (bla, bla, bla) nothing he can do.  He then sent me to an endo who said basically the same thing even after asking me about all of my symptoms (that obviously he could care less about).  Tried a third doctor who gets it! He said "well, you are in the normal range but at the very low end of normal. Based on your symptoms, I see no reason we can't try you on a trial period of TRT (test replacement therapy).  I explained I have a 3 year old daughter running around at home so he recommended Axiron (applied under the armpits).

So here we are now 30 days later after 60mg/day (1 pump each arm) with my follow up blood work.

My numbers went DOWN! What???

My total is now 310 and my free is below normal range at 4.01 (different lab with different range and units from quest 4.25 - 30.37).  I am perplexed and I don't see my doctor for another week.

I am here wondering if anybody has experienced something like this or can offer an explanation.

Many thanks in advance.

[Sam]

Hi Ken,

Welcome, you will get some great advice here.   I am relatively new also but can related to some of your situation.   Did you have any other blood work done?   You say you are gaining body fat but at 12% now which is quite good.  Are you being truthful on that?  If you are carrying around some extra pounds you can have a higher probability of conversion to estrogren so you would definitly need that test run (Estradiol - ultrasensitive, ie. LC/MS)

I have little kids too and am leaning towards shots or pellets if I ever get a Doctor to prescribe me HRT.  I am at 230 total and 46 free..  go figure right.

Good luck and I am sure others will chime in here soon, but additional details will help.

[Ken]

Hi Samson,

Thanks for the response.  Well the fat% is what the Tanita scale tells me and have pseudo calibrated in the past with caliper measurements.  It might have crept up to 13% possibly but it is in that range.  I was below 10% only 2 years ago.

Here are some other numbers that I got in the latest blood tests to answer your other questions:

Estradiol: 16.0 (range: 0 - 39.8 )
LH:            1.0 (range: 1.5 - 9.3)  ** This number looks like the result of the Axiron. No previous benchmark.
FSH:          1.9  (range: 1.4 - 18.1) **This number looks like the result of the Axiron. No previous benchmark.

PSA:          0.5 (range: <4.0)  Happy about this!

So it looks like I am not having a conversion to E2 problem.  Just don't understand how my numbers went down.  Maybe Dr will recommend upping dosage to 4 pumps a day from 2.  Then I just have to deal with Blue Cross headaches again to keep from going broke on the stuff!  The $25 card from Axiron is a joke.  Only pays up to $75 max.  If insurance hasn't signed off yet on it, 1 month will cost $260 with the card.  I guess this last part is for a different post.  Sorry.

[Sam]

It could be dose related.   From my research self-administered injections are the cheapest and most effective route ~($600-$1200/year) although once you have a sense of what your body needs pellets aren't a bad option.   From what i have heard pellets run about $500-600/implant 3-4 implants/year.

[Ken]

Thanks man!

So how do doctors prescribe injections for test cyp?  They give you a script and a box of needles?  I am not opposed to going this route.  Needles don't scare me.  Only down side to this approach from what I have read is the up and down cyclic nature between injections.

Interesting thing I found on Blue Cross pharmacy coverage is that any of the topical gels require certain authorizations and yet the vials of test-cyp do not.  No question here that $$$ is driving this practice. The test-cyp is cheap whereas the gels can run $400 to $600/month without insurance or insurance authorization.

For some reason I was thinking the injections would require me to go to the Dr office for every injection.

[PeakT]

The topicals just do not always work.  We've had a few guys on the forum who have had somewhat mixed results.  Notice this man got up to 540 with it:

https://www.peaktestosterone.com/forum/index.php?topic=84.0

However, this guys testosterone levels dropped like yours:

https://www.peaktestosterone.com/forum/index.php?topic=487.0

Again, though, if you poke around the forum at all, you'll notice many threads talking about Androgel failure where the person's testosterone drops post-administration.

One comment:  your estradiol is also lowish.  You've got to watch this for the following reasons:

http://www.peaktestosterone.com/Do_Men_Need_Estrogen

Injections are generally good from what I've seen as long as you are properly monitored including estradiol and are not done every two weeks (which will leave you hypogonadal for four days).

[Ken]

If the drop in my total T value wasn't enough, I started getting a rash in both armpits this past weekend.  Ugh! Burns like hell ! 

I had my Dr appointment moved up to this afternoon and I'm going to talk to him about injections.  100mg/week???

I figure if the Axiron was absorbing even at 10% this was 6mg/day or 42mg/week.  Clearly this was only enough to have my LH and FSH fall to nothing so that my net result was a lower overall T than what I started with.  So with 42mg do more bad than good, perhaps 100mg/week is the answer?

I will update this later after I see Doc.

[PeakT]

Guys tend to get 100-150 mg/ week of cypionate.  Your doc should know what he wants there.  If  he doesn't, then you might want to look at a new physician.

And sorry to sound like a broken record, but make sure the E2, hemo, PSA are monitored if you go on injections, cuzz it will definitely boost you.

Let us know what happens...

[Ken]

Thanks Peak!

So I just returned from the doctor and he did indeed give me my first injection at 100mg for 1 week.  I have 1-1/2 remaining CC's of 200mg/CC T Cyp.  He said to inject 1/2 CC every 7 days.  He then gave me a lab form that he checked off LH, FSH Estradiol, PSA, Total T, and Free T.  I go back in 4 weeks. He said we will adjust accordingly the dosage after we retest in 4 weeks. 

FYI, with Blue Cross insurance, my copay was $10 !!!!!!!! for this month.  Cost me $260 for 2nd month of Axiron without all kinds of doctor paperwork that they require for all of the topicals.  No paperwork for injections.

At 100mg/week dosage is their a lessor risk of my E2 popping way up?  I've heard that you have to get up to 200mg/week or more before AI's are really needed.  Any truth to that?

When do you think I might start feeling improvements from today's injection? 1 day, 3 days, a week??? On average of course, I realize everybody is different.

Thanks a lot for your inputs and advise.  Love your website!  Nicely done.

Ken

[JackAndy]

Wow that's a lot cheaper.

When do you think I might start feeling improvements from today's injection? 1 day, 3 days, a week??? On average of course, I realize everybody is different.

20 minutes? I could tell right away. Different benefits come over time and they say it takes up to 6 months to feel the full benefits. But yeah the first couple of days I was feeling great.

[PeakT]

At 100mg/week dosage is their a lessor risk of my E2 popping way up?  I've heard that you have to get up to 200mg/week or more before AI's are really needed.  Any truth to that?

When do you think I might start feeling improvements from today's injection? 1 day, 3 days, a week??? On average of course, I realize everybody is different.

Yes, less risk of E2 peaks, but that doesn't mean no risk.  Some guys are just high converters.

Improvements are very individual.  That's not a cop out - just the truth.  Anonymous had a mind blowing experience almost from day one.  And some guys have written in after a few months saying, "When will I feel anything?"  (Usually the latter haven't had their T boosted much though.)

But, generally, I would say it takes 6 weeks to 3 months to really notice the changes in sexual function if that is what you are asking.  Libido and mood often come along more rapidly.  Again, everyone is different.

[Ken]

Update:

Well, I have been on the 1st injection for only 48 hours and I actually do feel significantly better!  Happier, full of energy, even after my lunchtime gym workout! I realize placebo can be powerful, however, I doubt that is what is going on here, at least for the most part. My cardio output on the life cycle today was noticeably up in cal/minute as well as rpm with less fatigue afterward than what I had prior. I also woke up a couple of times during the night with wood that hasn't been around in that way for years!  I don't really have ED even before the HRT.  Just no automatic or random wood.  I could get wood if I got busy with the wife pretty easily, but I just had no interest in getting "busy".  Now half the girls that I previously barely noticed look pretty good.  Getting that animal like feeling again! Lastly I seem to be more clear headed, but this could be placebo.  I wasn't terribly foggy prior to be honest.

I suspect that my T levels are well above the 315 I had before but we'll get that checked in a few more weeks.  Something like the 4th or 5th day of the 7 day injection.

One small downside (literally) is my boys seem to be shrinking a bit.  Keep in mind before the injection 2 days ago I was on Axiron for 5 weeks that ended in failure as this thread title suggests. I guess this is to be expected.  I already have three great kids and don't want anymore anyway.  Is there any real health issue with these shrinking a bit?

I'll post again after my next bloodwork.

Cheers

[PeakT]

You wouldn't be the first to have an "explosively positive" experience with testosterone therapy.

Is he/she managing your estradiol?  The honeymoon will likely end in a few weeks if not.

You know that the testicular shrinkage issue can be managed with HCG, right?  It's pretty cheap usually:  $15 per week.  What I'm hearing is that you want lower dose injections about 3X/week.  Of course, talk to a knowledgeable doc about this if it's an issue.  (Usually it's the man who cares about testicular shrinkage not the woman.)

[Ken]

We are definitely going to monitor the E2.  But as I mentioned above, after 5 weeks of the Axiron my E2 was only 16.  I believe you (Peak) commented that this might almost be a bit low.  Of course after the injections I realize it may rise and we will continue to monitor it.  My body fat% is fairly decent (~12% - 13%) so I'm thinking that might keep the E2 in control.  But we will see in the next few weeks and months.

I am not familiar at all with HCG.  Can you please tell me more about this?  Sounds like more injections?  Script required I assume?  Side effects and benefits?  I am sure you can steer me to one of your great explanations somewhere on your site.

Thanks a lot!

[Ken]

Hi Peak,

You can forget about the HCG question and save your time.  I just found it on your website.  Your explanation in "HCG and Testosterone" was all I needed.  My shrinkage is minor to this point as you suggested in that article.

Probably don't need HCG at this point.  I agree that the wife won't care anyway.  If I see continued or troublesome atrophy I will revisit this topic.  Thanks for the heads-up on it though.

Cheers