When to take T dose on blood test days

[MikeC]

Hi,

Taking T has increased my hemoglobin count and my consultant is unhappy; so she has arranged monthly blood tests to see how it is progressing.

Depending on my schedule, I either (1) apply my entire dose at night; or (2) apply 1/2 at evening and 1/2 in the morning - generally I feel better with the 2 dose approach

My challenge
- Take 1 dose at night, and the 0900 blood test shows I am below the normal range, and she wants to increase my dose; and worries that my hemoglobin will increase
- Take the morning dose, and 4 hours later, my T is high and she wants to reduce it

I do not seem to be able to win; so, I thought I ask for help

When you do you normally take your T dose; and does this change on days you have a blood test?

Thanks

Mike

[Carl]

Hi Mike, you're on the gel I think?

I'm on the Nebido injection, which generally suits me and I'm lucky that my bloods (hemoglobin) are fine on the dose I'm taking....once every 12 weeks. Because my bloods are fine, the clinic manage me on mainly symptoms and T levels. As long as I'm not reporting fatigue or aches/pains and the T levels are fine at the 12-week ebb of my dose then they are happy if I'm happy. If my T levels were low at the end of the 12 weeks then they would move me to 10 weeks for instance. It seems fairly unscientific in a way. I asked whether they taper the dose as I get older - I'm in my late 50s now - and they said not necessarily, as long as the bloods and T levels and my symptoms remain stable they will continue to give the T levels of a 20 year old. I suppose I shouldn't complain!

[member_41389]

Hi Mike
I regularly apply Testogel in the morning. I confess that the results in terms of T levels are not great but since I'm being investigated for prostatitis or something related they won't increase the dose. I was told that the key thing when getting tests done was to ensure that they used the other arm; for example if I apply the gel to my left arm then the test sample must be taken from the right arm.
Hope this helps
Tim

[MikeC]

Carl - Given my other medical conditions, I just knew that injections would be a disaster, but my consultant insisted - and they were a disaster - I was sky high by day 3 and at 0 by day 7 -- it took 3 months to get my consultant to move to Gel - which works fine, except on blood test days.

M

[MikeC]

Tim

never thought about which arm I use - I will give it a try at the next blood test

Thanks

M

[MikeC]

All,

Had a chat to my consultant; she says that the dose should be applied once a day, in the morning after a shower/bath and be applied to the stomach/leg; every day.

On days of blood tests, 2 hours been application and blood being taken is sufficient.

I guess I'll see how that works.

[member_41389]

Funny that, the Testogel patient information leaflet now says apply to the shoulder/upper arm. It used to say upper arm or stomach but changed 18 months or so ago. I alternate arms to avoid irritation (the whole pfaff is irritating enough as it is).
Tim

[Carl]

I used to do alternate shoulder/upper arm as on PIL, but that didn't stop my skin getting very irritated after a few months, which was annoying. I certainly never applied it on my stomach or leg(s) - complete guess now, legs have a lot more muscle in them than arms (mine do anyway) perhaps the gel is better absorbed there?

[member_41389]

If I'm feeling awake tomorrow I might see if there's any data around. What's the betting that the advice is based on the design of the Phase 3 trial where they got the licence to use the stuff and no-one's domne any research on optimum location.
Tim

[MikeC]

Tim

Although using the gel is so much better than injections for me, I find the whole thing an annoyance, not helped by my consultant's insistence on following the written word and not thinking real world.

I am invariably up at 0500 and hit the gym at 0630, so my first shower of the day is sometime after 0730 at the gym and although rubbing the gel into my arm is not exactly embarrassing, I'd rather not do it in the gym changing. I would have thought that applying it at 0500 and showing at 0730 would have given it more than enough time to be absorbed and it a time where a bare arm is not a problem; but no, I have to do it after my shower, and stand shirtless until the gel dries.

As for location, I rotate through left/right arm and left/right leg, which gives my skin time to recover, so no problems with skin irritation.

I would help if they gave the rules for applying and not what they did in the trail.

M