Guidance required. Would u suggest then?

Based on the details you have shared, a drop in free testosterone from 11.7 to 10.7 ng/dL over just 20 days is not clinically significant and can be seen during the early phase of testosterone replacement therapy, especially with oral testosterone undecanoate, which has variable absorption and fluctuating serum levels. This is why most clinicians advise repeating hormone levels after 6–8 weeks, once steady-state levels are achieved, before making any treatment changes. Regarding the use of finasteride, your explanation is reasonable finasteride reduces conversion of testosterone to DHT and is commonly used in androgenic alopecia. It does not lower testosterone levels; in fact, serum testosterone may remain stable or slightly increase. Therefore, finasteride itself is not the cause of low testosterone, but it also does not “require” additional testosterone unless there is a true deficiency confirmed clinically and biochemically. Your concern about being advised Nebido (testosterone undecanoate 1000 mg injection) is understandable. Injectable testosterone does offer more stable and predictable testosterone levels compared to oral forms, which is why some doctors prefer it, especially for long-term replacement. However, injections are not mandatory if you are unwilling-oral therapy can be continued provided symptoms, hormone levels, liver profile, hematocrit, and lipids are regularly monitored. The trade-off is that oral testosterone may need higher or divided dosing and may still give fluctuating levels. With respect to vitamin B12, your level (168 pg/mL, as mentioned earlier) is clearly deficient, and correction is important because B12 deficiency can contribute to fatigue, low libido, mood symptoms, and poor response to hormone therapy. If you prefer to avoid injections, high-dose oral methylcobalamin (1500-2000 mcg daily) is an acceptable alternative in most cases, though response should be reassessed after 6-8 weeks. At this stage the most rational approach would be to continue your current oral testosterone regimen, correct reversible deficiencies such as B12 and vitamin D, avoid making rapid changes based on early lab fluctuations, and reassess hormones after 8 weeks along with SHBG, total testosterone, free testosterone, hematocrit, and liver profile.

A switch to injectable testosterone can be reconsidered later only if symptoms persist and levels remain suboptimal, not solely based on an early minor decline.

Please consult with endocrinologist.

You can consult me directly on Practo, or reach out via WhatsApp: Eight Seven Six Two Seven Four Nine Nine Seven Four I’ll guide you step-by-step with easy-to-follow treatment plans. Early consultation helps avoid complications — feel free to connect. Only whatsapp message no calls

You need endocrinologist

If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a free detailed discussion*

Avoid fried and spicy food Water intake more Do connect and consult