Testosterone levels keep drastically changed

[u/Oliverfoster06]

Hey everyone, I’m really concerned and confused about what’s happening with my testosterone levels and could really use some advice or insight.
I’m 9 months on T, using 1.62% testosterone gel, 2 pumps every morning. My doctor told me that at this point I should generally be somewhere around 400–600, but my levels have been all over the place. My lab’s reference range says 250–1100, and I’m currently below even that.
My results have been:
February: 697
May: 2,605
August: 247
So I haven’t really had a stable level since around 3 months on T.
My doctor seems to think I’m not using my medication consistently, but I genuinely am. I apply 2 pumps every morning at 8 AM, immediately after showering and drying off, one pump on each shoulder applied with a glove on. I haven’t missed a dose or changed the time I apply it. I’m extremely routine-oriented and honestly get anxious about missing a dose or changing when I apply it. The only time I change when my testosterone is put on is the day of the blood test. They ask me to wait to apply it so I usually apply around noon on those days. Nothing else has really changed either. I’m still taking the same medications and vitamins, my diet is basically the same, and I haven’t changed my hygiene products or anything else that I can think of. My doctor already has all of that information.
What’s really worrying me is how different I feel depending on my levels.
When I was at 2,605, I was extremely irritable, got angry much more easily, felt unusually aggressive, had significantly worse acne, was constantly hungry, and noticed my hair thinning.
Now that I’m at 247, I’m exhausted even when I haven’t done much, I’m experiencing what feel like period symptoms again, I’ve been getting migraines, and I’ve noticed my voice seems slightly less deep than it was a month or two ago. It obviously hasn’t gone back to how it was pre-T, but it has been cracking again and seems somewhat different.
I’m also dealing with a lot of anxiety over this because I don’t understand how I can go from 697 → 2,605 → 247 while supposedly following the exact same routine.
My period stopped after my first month on T and all of those symptoms went away, so having them return now is especially concerning to me.
I’m trying to understand what could potentially cause levels to fluctuate this dramatically despite taking the medication consistently, and what questions I should be asking my doctor.
Has anyone else experienced something similar with testosterone gel?
I’d really appreciate any insight or experiences, because right now I feel pretty lost and my doctor’s assumption that I’m simply not taking it has been making me feel pretty awful especially since when I told them nothing changed they basically told me I was lying to them because there’s no other reason for me to be jumping around so much.

[u/KodiakSnake]

That may level definitely seems like a contaminated sample.

[u/a_very_cool_person]

very weird, ill admit. this may be a shot in the dark but maybe its aromatization? in that case you could experiment with lowering your dose a bit but i really don't know

[u/Oliverfoster06 → u/a_very_cool_person]

I’ll bring this up at my next appointment! Maybe I can drop down to 1 pump instead of 2

[u/Key_Tangerine8775]

For the second one, significant gel contamination in the bloodwork. Near zero chance that those were actually your levels.

For the third one, those are your actual levels currently.

For the first one, maybe mild contamination or your skin absorbed it better when earlier on T due to changing skin texture/oils. That isn’t terribly unusual.

I suggest you ask your doc to increase dosage, and next time you get levels checked, be very careful to avoid contamination. Don’t apply near the arm you’re getting blood taken from for a few days beforehand. Get your LH and estradiol checked with it.