Posted 6/23/2017 1:17 PM (GMT -6)
Yeah, I did about two years on Androgel, then switched to testosterone cypionate injections for a year. Went off the shots in Feb. to try to figure out why my uPSA went detectable at .025 sometime during the 12 months preceding that. That would have been during the year I was on injections. Have been monitoring closely about monthly since then, hasn't varied much, and a uPSA check this week showed it at .018. So if it goes down another .004, I will again be "uPSA undetectable", at least on the LabCorp panel I get (lower limit .015).
When on the Androgel, did get into one go-round with BCBS. It did seem they were being kinda "unhelpful" about a renewal. But not for sure--coulda been my uro's nurse dropping the ball on paperwork. Never did get a clear explain. Like you, I used the three weeks without Androgel to get a T test (just before starting gel again). T was still pretty low. Actually found out in later tests that I was pretty low even on the gels.
Sorry the 850 T level is not doing much for you. My uro likes his guys 700 - 750 on TRT. I have hit low 700's at mid-cycle on injections. I feel so much better at that level than on the much lower T levels I got while on gel or when untreated. Much less fatigue, more mental clarity, seem calmer. Enough different that my wife notices and comments. Yes, could be mental only, and each man is different, but I really think it does something for me physically, too.
Was your 850 T test a while ago? Possible you are not absorbing the gel well anymore? Read the lit online, and you will see this is the case in a surprising percent of the gel users. Sure happened with me. So I discussed with my uro, and we agreed to try the injections. After his nurse trained me properly, and we settled on the dose that produced a good T level at midpoint of injection cycle, they have let me do all the shots at home now. On my last uro visit, he commented that switching to shots was the right thing to do.
Have you considered switching to shots? If you price T-cyp on web, you will see you can get a couple 10ml 200mg/ml bottles of T-cyp, with GoodRx coupon, for around $100 -- and that lasts me over a year. A couple bags full of syringes and needles are dirt cheap (I get the BD interlock syringes so you can easily switch out between 18 gauge needles to draw up the liquid, and 22 gauge to inject less painfully). So even if you went around BCBS and just paid out of pocket, you're looking at a whole year's worth for close to (I'll bet) what you pay for your part of about one month of Androgel. Give or take.
I actually did pay part of one of my semi-annual shot refills because, again, BCBS was being kinda “unhelpful” about some aspect of it. I just told the pharmacist, oh he**, here's cash instead. Insurance companies sure must not like the idea of testosterone replacement.
If you do wanna switch, be aware of:
-- your doc has to be ok with you self injecting, else the time/expense of weekly/biweekly office visits will kinda screw the whole deal (imho).
-- there is a normal up/down cycle in T blood level on shots -- way high for a few days after injecting, then way low just before time for next shot. Takes getting used to. Taking a half dose weekly, rather than full dose every other week, may ease this problem, if you don't mind sticking yourself more often.
I rarely bleed much after a shot and had no thigh scars after my year of injections.
-- frequent travelers will most likely find the gel packets more convenient
-- as Tall Allen guessed in my case (and it's looking like he was right), you may see a small amount of uPSA, perhaps from some unknown effect on some stray benign or bph tissue. This is really disconcerting if you have always been undetectable. And it may overcomplicate uPSA monitoring for recurrent cancer in any case. There does not seem to be much/any current literature that indicates TRT encourages PCa recurrence (excepting at low castrate t levels) -- though that is something you (and I) need to be aware of on TRT, because who knows for sure, right?
Good luck with your situation.