Hemoglobin

[madnomadtoo (imported)]

Three months ago I went to the urologist checkup, and my hemoglobin was 18.8. Doctor stopped T shots and advised taking low-dose aspirin.

Went back ten weeks later and T was was down from 700+ to 31. Hemoglobin was 16.4, which is still above my upper limit of 14.9

He suggested switching to Androgel, claiming it doesn't raise hemoglobin. I dislike Androgel, so he agreed on a lower dose T shot.

Apparently, the SOP now is testing my hemoglobin every few weeks, and if it's high go donate a pint of blood. Seems barbaric, but that was the advice he gave. In olden days I would go to the barber and have a little bloodletting. That's why barber poles have that red stripe.

BTW, T level at 31 was DEPRESSING. All I did was wallow around with a fuzzy brain. Maybe my mood would improve over time, but I dread the idea of running that gauntlet.

There should be a more elegant way to control this. Research?

[Losethem (imported)]

The doctor is definitely worried about blood clots in your blood stream. The blood is too "thick" which is why he's prescribing the low dose aspirin.

[TopManFL (imported)]

He suggested switching to Androgel, claiming it doesn't raise hemoglobin. I dislike Androgel, so he agreed on a lower dose T shot.

You don't mention why you dislike Androgel.

The two most common reasons are the smell and the cost.

The smell is really not an issue. It's just that another rub on gel brand name Testim has a strong smell. Some men swear they actually like the way testim smells (but, I suspect they also like that after shave with the ship on the bottle too). Androgel seriously has no smell other than it smells like alcohol for a few seconds when it's put on.

The cost is horrible for Androgel. With no insurance it's hundreds of dollars a month (compared with injections which run about $25 to $40 an injection). To bring the cost down I've found a compounding pharmacy nearby that will do a 90 days supply of a rub on testosterone cream for $115 (insurance doesn't cover it).

A prescription for Androgel is not just for the gel inside the bottle. If it were for the gel in the bottle, then your pharmacist could substitute any testosterone gel that delivers the same dose as Androgel. But, the prescription is for BOTH the gel and delivery system (which is the pump). Therefore, since the pump that delivers the gel is a patented pump, generic substitutions are not allowed.

However, find a compounding pharmacy and get the pharmacist to write down the compounding formula. Take that to the doctor and the price is a fraction of what Androgel is. It still comes in a pump (just not the same kind of pump). My pharmacist uses a white lotion that has no smell at all. He explained that the base for any medication delivered via a cream or lotion is a tricky business. The base has to "like" the medication well enough that it will mix together. But, once rubbed on the shoulders, the base has to "let go" of the medication - otherwise, it won't absorb.

I found this compounding pharmacy across the street from our local hospital. Yet, my doctor didn't even know compounded testosterone lotion was a possibility. But, once I got the two of them talking to each other it worked. Now, my doctor says he (and his NP) send almost all their TRT patients not on injections there.

With a compounded lotion, there's a "compounding fee" that is the same no matter if the pharmacist makes a one month or a three month supply for me. So, buying a three month supply at a time makes sense. Of the $115 price for three months, $40 is the compounding fee.

Some of the other reasons I've heard people don't like Androgel is that the smell of alcohol can be a trigger for a recovery alcoholic (I get that cause it does smell a bit like vodka. I think it smells more like rubbing alcohol), that it can transfer to other people (but, after market studies done where the man puts on the gel and then let's it dry and then gets naked under the covers with his wife showed no elevation in T levels in the wife. Still with kids about, it could be a concern), that it stings - if that's the case an alternative site can be used (for example if you have pimples on your shoulders) or just a bit less exfoliation in the shower might be in order.

Apparently, the SOP now is testing my hemoglobin every few weeks, and if it's high go donate a pint of blood. Seems barbaric, but that was the advice he gave. In olden days I would go to the barber and have a little bloodletting. That's why barber poles have that red stripe.

Yup. Too many red blood cells in men is a known problem. Some men actually find out they have too much hemoglobin because they keep setting of metal detectors at work or airports.

The treatment is to just open the tap and let some of the red blood cells out. Donating blood is the easiest way to do that. If you are in a category where you can't donate blood (cancer survivor, Hep C, Hep A or Hep B non immune, I think being Gay is no longer an exclusion or at least they talked about removing it from the list) then they just dispose of the blood.

Elevated hemoglobin does happen in women as well, but not as often. Having a period once a month is believed to be the reason why.

[madnomadtoo (imported)]

You don't mention why you dislike Androgel.

Uh, well, TBH many days I just forgot to apply it. When I did, I felt like I had to fan myself for five minutes before putting a shirt on. Then I felt like half of the dose was still on my hands, and I had to work like heck to scrub it off.

Plus, when my wife was living I didn't like telling her "DON'T TOUCH ME THERE!"

The Doc also suggested patches, but my fair skin blisters with hypoallergenic band-aids.

I don't mind needles, so I take the path of least hassle.

Maybe I'm weird, but I'm straight, had only one sex partner in life, and I've had Hep A and B vaccines, just because I could. So I'm sure the blood could be used, unless pizza contamination is possible.

It would be nice if T pills worked without killing your stomach, wouldn't it? How about a nasal version??? Would your nose grow like Pinocchio's? Or how about those syrettes like they used in the military?

[madnomadtoo (imported)]

Some men actually find out they have too much hemoglobin because they keep setting of metal detectors at work or airports.

Wow! That actually sounds cool, but dangerous.

Reminds me of something. I have a Geiger counter, and when we came home from one of my wife's radiation treatments I would hold it to her chest and watch it light up. It was funny at the time. You had to be there.

[gandalf (imported)]

I was switched to Fortesta. Cheaper than Androgel and I don't notice any alcohol smell. The difference is that Fortesta is a pump delivering 10 mg of Testosterone per pump where Androgel delvers 20.25 mg of Testosterone per pump. I always make sure the bathroom is warm when applying it, dries better. Although Fortests says put only on the thighs, my Dr. let me try it on the shoulders. No problem and seems to dry faster.

[TopManFL (imported)]

I was switched to Fortesta. Cheaper than Androgel and I don't notice any alcohol smell. The difference is that Fortesta is a pump delivering 10 mg of Testosterone per pump where Androgel delvers 20.25 mg of Testosterone per pump. I always make sure the bathroom is warm when applying it, dries better. Although Fortests says put only on the thighs, my Dr. let me try it on the shoulders. No problem and seems to dry faster.

To make the studies for the medications valid, every participate is instructed to use or take the medication the exact same way. So, since most humans have shoulders, they picked that spot for the rub on gels.

I've had minor things done like biopsies or a cut on my shoulder area and been unable to use that area until it was healed up and used my butt and stomach.

The one major thing I was told was to never rub it on the scrotum.

Apparently one of the first transdermal testosterone patches was rather large and placed on the shaved scrotum. This turned out to be a very bad idea as it was associated with an increase in testicular and prostate cancers. Honestly, I would never have confused my shoulder with my scrotum - but, glad he mentioned it.

[cutnbulls2ox (imported)]

Seems logical to use the scrotum as the place to apply the gel since its hanging there so willing and its where a man s testosterone used to come from, and not too many women or children handle or touch a man s scrotum by mistake to get any gel from it onto themselves. Men s wives would know if he was using his sack to absorb the gel. And most women are not big fans of playing with our nut bags much.

But if its a dangerous place to rub in the gel, I guess it shouldn t be used for it. But I can sure see why men would apply the T gel to their scrotums.

[seanthomas (imported)]

Welcome to the not-so-often-discussed negative of TRT. Like you, my hemoglobin is in the 18 range and my hemocrit was at 58 on my last CBC.

I have been completely off testosterone now for well over six months. Prior to that my dose was cut in half and yet that had no discernible effect on the blood. So far I've had three blood donations and yet each one is said to only lower the hemoglobin by 3%, so at this rate to get the numbers down to normal (14.7) will take a very long time.

Now the up side for me at least is, once my body adjusted, I really don't feel much different without the testosterone. So I see no benefits in incurring the expense and hassle of the gel as long as I don't have too many negative side effects. I still have energy, still maintain a reasonable sex drive, still get erections and have noticed no cognitive changes.

So therefore my only concern of being basically testosterone free is bone density loss, for which I will start back on a regular exercise regimen once able (I'm still healing from the removal of my scrotum) and take a calcium supplement.

[Eddie (imported)]

Seems logical to use the scrotum as the place to apply the gel since its hanging there so willing and its where a man s testosterone used to come from, and not too many women or children handle or touch a man s scrotum by mistake to get any gel from it onto themselves. Men s wives would know if he was using his sack to absorb the gel. And most women are not big fans of playing with our nut bags much.

But if its a dangerous place to rub in the gel, I guess it shouldn t be used for it. But I can sure see why men would apply the T gel to their scrotums.

But your scrotum does touch during sexual intercourse. Androgel does state not to use on scrotum.