Anyone combine injections and cream? How do you feel?

MNguy said:

Interesting anecdote. I’m curious what what your SHBG and current protocol are?

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JoeMatts said:

This was my experience with TRT, too.

On weekly injections I always found that I felt the best a day or two before my next shot was due, around 650 ng/dl. Then, a day or so after my next injection when levels hit > 1000 ng/dl, erections and libido would disappear again, water retention would go up and brain fog would return. As I moved to a higher injection frequency and higher levels were kept more constant, my sexual function was lost outright.

Deep down I always knew that I felt better at lower level, but I didn't want to believe it. Everyone thinks that they can make extremely high levels work - mainly because they think it'll confer them an 'advantage' over naturals re: muscle, sexual function, energy, etc - but for most, it doesn't work that way.

Instead of acknowledging that it was the high testosterone itself causing the issues, I instead looked for scapegoats in estradiol, HCG, adrenal hormones, etc, as the cause of all my hormone-related issues. In reality, the real problem was staring me in the face the entire time, but I chose not to see it.

Years of time and energy wasted due to that mindset.

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thyronine said:

Same experience here.
Keeping my total testosterone above 34 nmol/l (1000 ng/dl) causes erectile dysfunction, absent libido, severe physical anxiety, hairloss, bloat, cognitive impairment, high blood pressure, elevated prolactin + estradiol + HCT, reduced HDL - the list could go on.
My current protocol is 50iu HCG + 50 mg transcrotal cream (1 click / 0.25g compounded 20%) every morning. This has my levels at 20 nmol/l (600 ng/dl) upon waking + pre-administration, rising to ~28 nmol/l (850ng/dl) four hours post-cream application.
Sexual function is great, anxiety is gone, heart no longer pounds in bed at night, blood pressure is 120/80 and water retention resolved entirely.
I also take 5mg DHEA and 12.5mcg T4, which along with the above keeps T, DHEA, Prog and T3/4 in the top quarter of their respective ranges, whilst TSH, prolactin and estradiol are all low-normal. Occasionally I'll take 12.5mg of proviron for the mental boost it brings, but that's a rarity these days.
Balanced would be the best word to describe how I currently feel.

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thyronine said:

Same experience here.
Keeping my total testosterone above 34 nmol/l (1000 ng/dl) causes erectile dysfunction, absent libido, severe physical anxiety, hairloss, bloat, cognitive impairment, high blood pressure, elevated prolactin + estradiol + HCT, reduced HDL - the list could go on.
My current protocol is 50iu HCG + 50 mg transcrotal cream (1 click / 0.25g compounded 20%) every morning. This has my levels at 20 nmol/l (600 ng/dl) upon waking + pre-administration, rising to ~28 nmol/l (850ng/dl) four hours post-cream application.
Sexual function is great, anxiety is gone, heart no longer pounds in bed at night, blood pressure is 120/80 and water retention resolved entirely.
I also take 5mg DHEA and 12.5mcg T4, which along with the above keeps T, DHEA, Prog and T3/4 in the top quarter of their respective ranges, whilst TSH, prolactin and estradiol are all low-normal. Occasionally I'll take 12.5mg of proviron for the mental boost it brings, but that's a rarity these days.
Balanced would be the best word to describe how I currently feel.

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SSHSSA74 said:

What is your SHBG?

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Willyt said:

Have you tried this protocol without the HCG?

I ask because I’ve wondered whether trans scrotal cream at 1x per day would avoid shut down of upstream hormones since the cream is short acting without ester (i.e., similar to Natesto). In theory it would allow you to return to baseline T trough before the next application. However not sure if scrotal cream clears system quickly enough.

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thyronine said:

I haven't, unfortunately.
However, although test base has a short half life, the cream itself still takes a little while to absorb - I think that'd be enough to keep the HPTA suppressed.
Injectable test base would be the only way to test such theory.

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camygod said:

do you know absorption % of transcrotal test cream
approximately how much of the 50mg you would absorb

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camygod said:

do you know absorption % of transcrotal test cream
approximately how much of the 50mg you would absorb

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ERO said:

I have tried combinations of injectable T Cyp + cream, injectable T Prop + cream, cream alone, in various dosages and feel no better. Low SHBG person, so in theory this should have helped. I know the combination works well for some guys.

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thyronine said:

Have you had your thyroid function assessed - labs, but also body temperature, achilles reflex and general symptoms? I never found much benefit from TRT until I got my TSH below 1, with pre-thyroid treatment levels hovering between 2.5 - 5 (fT3/4 were always 'optimal').
Hypothyroidism can cause low SHBG; like testosterone, being within range doesn't = normal.
If achieving an optimal level of free testosterone on a reasonable protocol fails to resolve symptoms, the symptoms aren't related to testosterone. People waste years tweaking their dose, frequency, administration method, etc, trying to resolve symptoms that aren't related to testosterone because they view TRT as a panacea. However, exogenous testosterone will only fix symptoms that originate as a by-product of low testosterone; most issues attributed to low testosterone aren't actually caused by low testosterone. Just my 2c.

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thyronine said:

Have you had your thyroid function assessed - labs, but also body temperature, achilles reflex and general symptoms? I never found much benefit from TRT until I got my TSH below 1, with pre-thyroid treatment levels hovering between 2.5 - 5 (fT3/4 were always 'optimal').
Hypothyroidism can cause low SHBG; like testosterone, being within range doesn't = normal.
If achieving an optimal level of free testosterone on a reasonable protocol fails to resolve symptoms, the symptoms aren't related to testosterone. People waste years tweaking their dose, frequency, administration method, etc, trying to resolve symptoms that aren't related to testosterone because they view TRT as a panacea. However, exogenous testosterone will only fix symptoms that originate as a by-product of low testosterone; most issues attributed to low testosterone aren't actually caused by low testosterone. Just my 2c.

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eyeheartny said:

Cortisol is low but follows the normal curve pattern, I assume it is suppressed because of testosterone treatment long-term. I had also slept terribly the night before the test. Since then I've tried adding hydrocortisone and felt horrible as well, so I don't think cortisol is the issue. On both T4 and HC, my HRV dipped a lot and my body showed signs of stress at night (according to Oura ring) so I backed off both and felt better after a washout period.

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engineer said:

Could you please elaborate on this?? My cortisol is low... ultra low to the point that I only wake up after 2PM. Hydrocortisone helps a lot but at what dose does it become “dangerous”?

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eyeheartny said:

It sounds like you need some expert help on that, and I am not that expert. If you're having trouble waking up that late I'd seek medical attention and help-- that sounds really difficult and could be related to serious endocrine issues. Also, dosing of HC and those protocols is way outside of my knowledge and I would not want to lead you astray. I would strongly recommend getting medical attention on all this as this sounds different than the issues I was contending with.

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engineer said:

Thanks for your reply!

My thyroid numbers are great, my Test levels are high, but I am still sleepy.... I have been asking for help to the medical community for 4 years with no one listening to me other than prescribing stimulants/antidepressants. And they didn't help unfortunately.

However, Dr. Saya (from Defy Medical) put me on a trial dose of hydrocortisone this year (10mg/day) after seeing my cortisol so low in blood work and correlating to my symptoms. It helped instantaneously. I called Defy and requested an additional dose so now I take 10mg, twice a day. So I am being helped out.

The question was more related to my lack of understanding of how increasing testosterone levels causes severe fatigue in me.....

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