Androgel Not working

[madman]

I heard oral t affects kidneys? And is very expensive?

You would mean liver.

When it comes to testosterone therapy methyltestosterone was the older original c-17 alpha alkylated oral formulation used which had been linked to such!

It is no longer used and was replaced by Andriol (oral TU) which bypasses the liver.

More recently there are 3 new oral TU formulations (Jatenzo, Tlando and Kyzatrex) which are much more effective then the older outdated Andriol testocaps and also pose no liver toxicity.

* [1]. Systemic delivery of oral TU occurs instantly (>97%) via the intestinal lymphatic system thus bypassing the liver completely.

Liver toxicity would be related to any of the c-17 alpha orals.

The use of exogenous T for testosterone replacement in men whether in the form of intranasal (Natesto®), patch, pellets, oral (Jatenzo®, Tlando®, Kyzatrex® ), buccal, transdermal (gel/cream), injectable (short, medium, or long-acting, mixed esters) does not cause any harm to the liver/kidneys.

It would be the use of AAS 17α-alkylated orals such as stanozolol, oxandrolone, methyltestosterone, methandrostenolone, oxymetholone, and fluoxymesterone as they are notorious for driving down HDL, increasing LDL, stressing the liver and hammering down SHBG.

Even then the dose/duration of use will play a big role.

Newer formulations of oral testosterone: development and liver side effects

Abstract Introduction Testosterone deficiency is a clinical disorder due to either failure of the testes to produce testosterone or failure of the hypothalamus or pituitary to produce sufficient gonadotropins. Previous formulations of oral testosterone therapy, particularly...

www.excelmale.com

Oral Testosterone Therapy in Hypogonadal Men: A Comprehensive Systematic Review

Introduction Background and significance Hypogonadism, characterized by low testosterone levels, is a significant clinical condition affecting a substantial proportion of the male population, particularly older men. The management of hypogonadism often involves testosterone replacement therapy...

www.excelmale.com

Safety, efficacy, and pharmacokinetics of oral TU in males with hypogonadism

Abstract Background Testosterone deficiency results from insufficient testosterone production. Testosterone therapy may require dose titration to reach eugonadal serum testosterone concentrations. Objective The primary objective was the efficacy of oral testosterone undecanoate (TLANDO...

www.excelmale.com

Oral TU - Safety/Efficacy

@granger https://www.excelmale.com/threads/2-year-follow-up-data-of-oral-testosterone-capsule-jatenzo.23453/ Two-Year Analysis of a New Oral Testosterone Undecanoate (TU)Formulation in Hypogonadal Men: Efficacy, Impact on PsychosexualFunction, and Safety (2022)

www.excelmale.com

Controversies with Testosterone Replacement Therapy: Lecture by Dr Khera

As usual Nelson's Excel is where it's at! Mohit Khera, MD, MBA, MPH, Professor of Urology, F Brantley Scott Chair in Urology, Medical Director of the Laboratory for Andrology Research, Medical Director for the Scott Department of Urology Baylor College of Medicine.

www.excelmale.com

Oral testosterone. Who's on it?

Who here is on some form of oral. jatenzo/Kyzatrex? What has it done for you? What are your numbers? Has RBC increases been as much as a problem for you on the orals? How is your liver tests? Thank you

www.excelmale.com

Oral testosterone. Who's on it?

Who here is on some form of oral. jatenzo/Kyzatrex? What has it done for you? What are your numbers? Has RBC increases been as much as a problem for you on the orals? How is your liver tests? Thank you

www.excelmale.com

A phase III, single-arm, 6-month trial of a wide-dose range oral TU (Kyzatrex) product

Abstract Background Oral testosterone undecanoate (TU) formulations may provide effective, safe, and easily titratable testosterone replacement therapy. Objective Demonstrate efficacy and safety of a novel oral TU formulation. Design An open-label, single-arm, multi-center trial treated...

www.excelmale.com

Maximus: Oral TRT+ (native T + enclomiphene + pregnenolone)

Because the oral testosterone need hundreds of mg, it requires a specially formualted tablet to get absorbed by the lymphatic system. I'm on Jaetnzo @237 mg twice daily, or 3318 mg per week.

www.excelmale.com

My short-term Dbol-only experiment. Or, “How I learned to stop worrying and love oral anabolics”. Part-1

Hey guys. I am nearing the completion of a 3 week Dbol as TRT experiment and wanted to post the protocol and results. I will follow up with the next phase with bloodwork later this Spring. About me: 57 y/o life time lifter TRT for the past 5 1/2 years Normal Protocol is 80 mg Test, 120...

www.excelmale.com

ORAL LPCN 1148 IMPROVES SARCOPENIA AND CLINICAL OUTCOMES INPATIENTS WITH DECOMPENSATED CIRRHOSIS

www.excelmale.com

How i finally found a way to go subQ and why i wished....

Hello fellas, i have opened a thread a couple months ago where I wrote how Everytime I try to go subQ TRT after 2-3 weeks it's like i am off TRT... I have tried this 3! Times and always ended up going intra muscular again. I didn't have any problems with IM injections. But I wanted to inject 3...

www.excelmale.com

Novel Approach for the Management of Liver Cirrhosis

https://ir.lipocine.com/events?item=45

www.excelmale.com

Use of oral and injectable testosterone undecanoate TRT

Safety Aspects and Rational Use of Testosterone Undecanoate in the Treatment of Testosterone Deficiency: Clinical Insights (2023) Katherine Campbell, Akhil Muthigi, Armin Ghomeshi, Kyle Schuppe, Max D Sandler, Ranjith Ramasamy Abstract Testosterone deficiency is diagnosed by a serum total...

www.excelmale.com

Oral testosterone therapy

Oral testosterone therapy: past, present, and future (2023) Jake A. Miller, MD, Tuan T. Nguyen, MD, Charles Loeb, MD, Mohit Khera, MD, Faysal A. Yafi, MD Abstract Introduction: Testosterone replacement therapy (TRT) remains a commonly utilized treatment for men with testosterone deficiency...

www.excelmale.com

Kyzatrex - Oral testosterone replacement therapy

Kyzatrex - Oral testosterone replacement therapy (2022) Adam Ali Asghar *, Mahnoor Rehan Hashmi, Rushaan Ahmed, Yumna Khabir Male hypogonadism, characterized by the body’s inability to secrete sufficient amounts of testosterone [1], affects approximately 40% of men over the age of 45 globally...

www.excelmale.com

Oral TU offers a safe and effective long-term treatment option for men with hypogonadism

Two-Year Analysis of a New Oral Testosterone Undecanoate (TU) Formulation in Hypogonadal Men: Efficacy, Impact on Psychosexual Function, and Safety (2022) Stanton Honig, MD, Marc Gittelman, MD, Jed Kaminetsky, MD, Christina Wang, MD, John K. Amory, MD, Nestor Rohowsky, MA, Robert E. Dudley...

www.excelmale.com

KYZATREX (oral testosterone undecanoate) now available in all states across the US

https://www.kyzatrex.com/prescriber.html KYZATREX (testosterone undecanoate) is an oral testosterone replacement therapy specifically designed for adult males with conditions associated with a deficiency or absence of endogenous testosterone, such as primary hypogonadism and hypogonadotropic...

www.excelmale.com

Oral TRT Products: Jatenzo, Tlando, Kyzatrex, & DiTest

Testosterone Replacement Therapy: A Narrative Review with a Focus on New Oral Formulations (2022) Salman Z Bhat and Adrian S Dobs Male hypogonadism affects 10–30% of the male population and is often under-recognized and under-treated. Different replacement formulations exist, each with...

www.excelmale.com

FDA Approves Oral Testosterone Replacement Therapy Kyzatrex

Another oral testosterone undecanoate. https://www.empr.com/home/news/fda-approves-oral-testosterone-replacement-therapy-kyzatrex/

www.excelmale.com

 

[Rclouviere]

You would mean liver.

When it comes to testosterone therapy methyltestosterone was the older original c-17 alpha alkylated oral formulation used which had been linked to such!

It is no longer used and was replaced by Andriol (oral TU) which bypasses the liver.

More recently there are 3 new oral TU formulations (Jatenzo, Tlando and Kyzatrex) which are much more effective then the older outdated Andriol testocaps and also pose no liver toxicity.

* [1]. Systemic delivery of oral TU occurs instantly (>97%) via the intestinal lymphatic system thus bypassing the liver completely.

Liver toxicity would be related to any of the c-17 alpha orals.

The use of exogenous T for testosterone replacement in men whether in the form of intranasal (Natesto®), patch, pellets, oral (Jatenzo®, Tlando®, Kyzatrex® ), buccal, transdermal (gel/cream), injectable (short, medium, or long-acting, mixed esters) does not cause any harm to the liver/kidneys.

It would be the use of AAS 17α-alkylated orals such as stanozolol, oxandrolone, methyltestosterone, methandrostenolone, oxymetholone, and fluoxymesterone as they are notorious for driving down HDL, increasing LDL, stressing the liver and hammering down SHBG.

Even then the dose/duration of use will play a big role.

Newer formulations of oral testosterone: development and liver side effects

Abstract Introduction Testosterone deficiency is a clinical disorder due to either failure of the testes to produce testosterone or failure of the hypothalamus or pituitary to produce sufficient gonadotropins. Previous formulations of oral testosterone therapy, particularly...

www.excelmale.com

Oral Testosterone Therapy in Hypogonadal Men: A Comprehensive Systematic Review

Introduction Background and significance Hypogonadism, characterized by low testosterone levels, is a significant clinical condition affecting a substantial proportion of the male population, particularly older men. The management of hypogonadism often involves testosterone replacement therapy...

www.excelmale.com

Safety, efficacy, and pharmacokinetics of oral TU in males with hypogonadism

Abstract Background Testosterone deficiency results from insufficient testosterone production. Testosterone therapy may require dose titration to reach eugonadal serum testosterone concentrations. Objective The primary objective was the efficacy of oral testosterone undecanoate (TLANDO...

www.excelmale.com

Oral TU - Safety/Efficacy

@granger https://www.excelmale.com/threads/2-year-follow-up-data-of-oral-testosterone-capsule-jatenzo.23453/ Two-Year Analysis of a New Oral Testosterone Undecanoate (TU)Formulation in Hypogonadal Men: Efficacy, Impact on PsychosexualFunction, and Safety (2022)

www.excelmale.com

Controversies with Testosterone Replacement Therapy: Lecture by Dr Khera

As usual Nelson's Excel is where it's at! Mohit Khera, MD, MBA, MPH, Professor of Urology, F Brantley Scott Chair in Urology, Medical Director of the Laboratory for Andrology Research, Medical Director for the Scott Department of Urology Baylor College of Medicine.

www.excelmale.com

Oral testosterone. Who's on it?

Who here is on some form of oral. jatenzo/Kyzatrex? What has it done for you? What are your numbers? Has RBC increases been as much as a problem for you on the orals? How is your liver tests? Thank you

www.excelmale.com

Oral testosterone. Who's on it?

Who here is on some form of oral. jatenzo/Kyzatrex? What has it done for you? What are your numbers? Has RBC increases been as much as a problem for you on the orals? How is your liver tests? Thank you

www.excelmale.com

A phase III, single-arm, 6-month trial of a wide-dose range oral TU (Kyzatrex) product

Abstract Background Oral testosterone undecanoate (TU) formulations may provide effective, safe, and easily titratable testosterone replacement therapy. Objective Demonstrate efficacy and safety of a novel oral TU formulation. Design An open-label, single-arm, multi-center trial treated...

www.excelmale.com

Maximus: Oral TRT+ (native T + enclomiphene + pregnenolone)

Because the oral testosterone need hundreds of mg, it requires a specially formualted tablet to get absorbed by the lymphatic system. I'm on Jaetnzo @237 mg twice daily, or 3318 mg per week.

www.excelmale.com

My short-term Dbol-only experiment. Or, “How I learned to stop worrying and love oral anabolics”. Part-1

Hey guys. I am nearing the completion of a 3 week Dbol as TRT experiment and wanted to post the protocol and results. I will follow up with the next phase with bloodwork later this Spring. About me: 57 y/o life time lifter TRT for the past 5 1/2 years Normal Protocol is 80 mg Test, 120...

www.excelmale.com

ORAL LPCN 1148 IMPROVES SARCOPENIA AND CLINICAL OUTCOMES INPATIENTS WITH DECOMPENSATED CIRRHOSIS

www.excelmale.com

How i finally found a way to go subQ and why i wished....

Hello fellas, i have opened a thread a couple months ago where I wrote how Everytime I try to go subQ TRT after 2-3 weeks it's like i am off TRT... I have tried this 3! Times and always ended up going intra muscular again. I didn't have any problems with IM injections. But I wanted to inject 3...

www.excelmale.com

Novel Approach for the Management of Liver Cirrhosis

https://ir.lipocine.com/events?item=45

www.excelmale.com

Use of oral and injectable testosterone undecanoate TRT

Safety Aspects and Rational Use of Testosterone Undecanoate in the Treatment of Testosterone Deficiency: Clinical Insights (2023) Katherine Campbell, Akhil Muthigi, Armin Ghomeshi, Kyle Schuppe, Max D Sandler, Ranjith Ramasamy Abstract Testosterone deficiency is diagnosed by a serum total...

www.excelmale.com

Oral testosterone therapy

Oral testosterone therapy: past, present, and future (2023) Jake A. Miller, MD, Tuan T. Nguyen, MD, Charles Loeb, MD, Mohit Khera, MD, Faysal A. Yafi, MD Abstract Introduction: Testosterone replacement therapy (TRT) remains a commonly utilized treatment for men with testosterone deficiency...

www.excelmale.com

Kyzatrex - Oral testosterone replacement therapy

Kyzatrex - Oral testosterone replacement therapy (2022) Adam Ali Asghar *, Mahnoor Rehan Hashmi, Rushaan Ahmed, Yumna Khabir Male hypogonadism, characterized by the body’s inability to secrete sufficient amounts of testosterone [1], affects approximately 40% of men over the age of 45 globally...

www.excelmale.com

Oral TU offers a safe and effective long-term treatment option for men with hypogonadism

Two-Year Analysis of a New Oral Testosterone Undecanoate (TU) Formulation in Hypogonadal Men: Efficacy, Impact on Psychosexual Function, and Safety (2022) Stanton Honig, MD, Marc Gittelman, MD, Jed Kaminetsky, MD, Christina Wang, MD, John K. Amory, MD, Nestor Rohowsky, MA, Robert E. Dudley...

www.excelmale.com

KYZATREX (oral testosterone undecanoate) now available in all states across the US

https://www.kyzatrex.com/prescriber.html KYZATREX (testosterone undecanoate) is an oral testosterone replacement therapy specifically designed for adult males with conditions associated with a deficiency or absence of endogenous testosterone, such as primary hypogonadism and hypogonadotropic...

www.excelmale.com

Oral TRT Products: Jatenzo, Tlando, Kyzatrex, & DiTest

Testosterone Replacement Therapy: A Narrative Review with a Focus on New Oral Formulations (2022) Salman Z Bhat and Adrian S Dobs Male hypogonadism affects 10–30% of the male population and is often under-recognized and under-treated. Different replacement formulations exist, each with...

www.excelmale.com

FDA Approves Oral Testosterone Replacement Therapy Kyzatrex

Another oral testosterone undecanoate. https://www.empr.com/home/news/fda-approves-oral-testosterone-replacement-therapy-kyzatrex/

www.excelmale.com

Perfect. Thanks for the reply

 

[Rclouviere]

Seeing as you have been using the TD gel for 12 months then you were clearly benefiting in some way as it is highly doubtful one would put up with feeling shitty that long!

Have no clue where your TT/FT level sits on such as you never posted labs but if you are dosing the 1.62% (4 pumps daily) and are not hitting a high enough FT then you are a poor responder.

The bioavailability of transdermal T (standard application) is around 9-13%.

*Only approximately 10 % of the testosterone applied on the skin surface is absorbed into the circulatory system during a 24-h period.

Most men using the standard 1% Androgel packets or 1% Testim tubes would need the higher-end daily dose of 100 mg T (10 mg T/day) to achieve stellar/high FT levels and again that is if you have no issues with absorption!

Some men can easily achieve a high-end/high TT and more importantly FT level when using the big pharma TD gels but the higher-end dose would be needed.

Unfortunately many men end up being poor responders due to issues with absorption of the transdermal T (standard body application).

In most cases this can be easily remedied by switching to a higher strength compounded T cream applied scrotally!

If anything you could give Testim a go before throwing in the towel as it has been shown to be more effective than Androgel possibly due to the addition of an emollient which can improve absorption.

Just keep in mind whether using Androgel or Testim the higher end dose would be needed in most cases in order to achieve a high-end/high TT/FT level.

If you do not fare well on such due to issues with absorption than a higher strength compounded T cream applied scrotally would be the most sensible move.

If you are ready to move on then oral TU (Jatenzo, Kyzatrex or Tlando) or injectable TC/TE/TP/T-blend is where it's at!

I would give Kyzatrex a go before jumping on injections as oral TU would be a superior formulation when it comes to minimizing sides especially elevated hematocrit!




*Additionally, some gels include emollients that prevent skin drying and ensure better testosterone absorption. There are data to suggest that this may help achieve better bioavailability and higher serum concentrations [37].

[37] Evaluation of the Pharmacokinetic Profiles of the New Testosterone Topical Gel Formulation, TestimTM, Compared to AndroGel (2003)
T. Marbury, E. Hamill, R. Bachand, T. Sebree and T. Smith








2.2.2) Testosterone Gel

There is a wide range of topical products on the market: Tostrex (Tostran, Fortesta), Androgel (Testogel), Testim and Axiron (solution), and Testavan, which is a 2% testosterone gel, currently under registration in Europe and already approved in Australia in May 2017. In Japan too, a new 2% gel is being developed [16]. Androgel 1% (5 g for 50 mg of T) was the pioneer in topical gel applications. In the EU, it was marketed as Androgel 1.62 (2.5 g for 40.5 mg of T). Then came Testim (Testosterone 1%, 5g for 50 mg of T), followed Tostrex (Tostran), sold as a 2% gel with a starting dose of 3 g (60 mg of testosterone. Fortesta (40 mg of T applied to inner thighs) and Axiron (3ml for 30 mg of T applied to each underarm) are also both 2% testosterone solutions. Testavan, also a 2% testosterone gel, is made of a hydroalcoholic and highly viscous topical formulation (1.15 g for 23 mg of T up to 3.45 g for 69 mg of T). A metered dose dispenser including a hands-free cap applicator allows for minimizing exposure to the hands and potential contamination of other people.




Otherwise you would need to look into a compounded higher strength cream which can be applied standard body application or scrotally which would be superior when it comes to absorption of the T.

Look over the paper (pdf) in this post which is the most up to date paper on Transdermal androgens!

New TRT user and frustrated on 1.62 Gel

I’m 47 and low T, low energy and no gym gains. I’ve had issue with ED and my libido at the moment is nonexistent right now. 2 months ago my TEST was 160 and my free T was 11 pg/ml! My PA started me on 1 pump per day alternating shoulders and then bumped me to 2 pumps per day (one pump each...

www.excelmale.com

Got Test results after 3 months 1% T-Gel . . . very rattled!

I'm 68 and was diagnosed in December with lower T at 314, hematocrit at 47. I decided together with the Endocrinologist to go with his suggestion of 5gms 1% T Gel, the regular starting dose. Fast forward to my first blood test taken yesterday after applying the gel regularly for 3 months. And...

www.excelmale.com

*Some manufacturers provide both options (Table 11.2). Most testosterone gel preparations are formulated as hydroalcoholic gel, others use other enhancers in lotions. When applied to the skin, testosterone is absorbed into the stratum corneum over time, which serves as a reservoir. Testosterone is slowly released into the circulatory system over several hours resulting in steady-state serum levels of the hormone [22]. The release of testosterone from the reservoir continues for about 24 h. Only approximately 10 % of the testosterone applied on the skin surface is absorbed into the circulatory system during a 24-h period.


*Long-term studies with testosterone gel have shown that steady and relatively consistent serum levels of testosterone levels are attained [7],


*Several formulations of testosterone gels are available on the market [1, 2, 27]. Currently available gels vary in testosterone concentration and are usually applied once a day. Their pharmacokinetic profiles are also similar: Androgel 1 %®/ Testogel 1 %® [7], Testim® 1 % [28], Axiron®2 % [29] Fortesta Gel® 2 %/Tostran® 2 % [30], and Androgel 1.62 %® [31]. These transdermal preparations have been proven to be efficient in normalizing serum levels, as well as the reversal of androgen deficiency symptoms for long periods of treatment [24], and have been considered an acceptable form of testosterone substitution by users [5]. The maximum concentration of testosterone achieved is variable depending on the preparation but usually within 2–5 h of application and is maintained for 24 h. When applied in the morning, a profile somewhat similar to the circadian rhythm in healthy men is maintained. Recent studies in older hypogonadal men have shown that after testosterone gel application there were large fluctuations in serum testosterone concentration both within and between patients [8]. Skin structural differences may be one of the causes of these significant variations in the bioavailability of the drug, which poses challenges in predicting the effectiveness of medication and determining an adequate dose, as well as an appropriate time for testing serum testosterone levels [8, 32]. Nontime-dependent pulses of serum testosterone also occur in relation to exercise and skin temperature. Both factors may be mediated through changes in dermal blood flow. Another important issue is the possibility of blood sample contamination when it is drawn at the gel application site, which has led to a spurious increase in measured testosterone levels [33]. A sampling of blood after testosterone gel applications should be done away from the application sites.


*Additionally, some gels include emollients that prevent skin drying and ensure better testosterone absorption. There are data to suggest that this may help achieve better bioavailability and higher serum concentrations [37]. Differences in gel formulations and their pharmacokinetic profiles are a reason why gels cannot be used and dosed interchangeably. Therefore, it is recommended to follow specific instructions on sites for application and dosing of the drug provided in the labeling. Dosing information and recommendations for some of the preparations are presented in Table 11.2. It should be noted that some gels are marketed in various countries under different names but are in fact produced by the same manufacturer.


*At day 90, peak T levels were reached after 4 and 8 hours with 5 g and 10 g T gel application, respectively.

Looks like the study only discusses that Testim T rates are higher than Androgel. My issue is there is No increase in testesterone using Androgel. However, I assume, based on the 2007 study, Testim is better absorbed?

 

[madman]

I heard oral t affects kidneys? And is very expensive?

Can't get it up... Ferritin that is. Blood issues after 5 years. HCG related question. Labs attached.

I have been on TC for over 5 years with varying results, mostly positive until the last year. I have had to do a few blood donations within the last 3 years due to rising HCT. It dropped my ferritin levels to 10, range 30 - 400. I can't get my ferritin levels up. My Mayo PCP said that if I take...

www.excelmale.com

 

[madman]

Looks like the study only discusses that Testim T rates are higher than Androgel. My issue is there is No increase in testesterone using Androgel. However, I assume, based on the 2007 study, Testim is better absorbed?

Your best bet would be looking into a higher strength compounded T cream scrotal application which would allow one to easily overcome issues with absorption let alone hit high/very high T levels!

Otherwise I would try oral TU before moving on to injections.

Do what you feel is best for you!

Pharmacokinetics of testosterone cream applied to scrotal skin

Conclusion *we concluded that the scrotal administration of testosterone in a cream formulation provides high bioavailability, dose-dependant peak serum testosterone concentration, and tolerability with a much lower dose relative to the non-scrotal transdermal route *further studies of...

www.excelmale.com

Case Study: Absorption of Testosterone Cream via Scrotal Delivery

Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...

www.excelmale.com

ABSORPTION OF TESTOSTERONE CREAM VIA SCROTAL DELIVERY (2018)

ABSTRACT Transdermal testosterone has been used for years to treat patients with low testosterone symptoms. Clinically, we have monitored patients to evaluate results of testosterone absorption via blood serum concentrations. The data on multiple time points to determine trough and peak...

www.excelmale.com

 

[Rclouviere]

Your best bet would be looking into a higher strength compounded T cream scrotal application which would allow one to easily overcome issues with absorption let alone hit high/very high T levels!

Otherwise I would try oral TU before moving on to injections.

Do what you feel is best for you!

Pharmacokinetics of testosterone cream applied to scrotal skin

Conclusion *we concluded that the scrotal administration of testosterone in a cream formulation provides high bioavailability, dose-dependant peak serum testosterone concentration, and tolerability with a much lower dose relative to the non-scrotal transdermal route *further studies of...

www.excelmale.com

Case Study: Absorption of Testosterone Cream via Scrotal Delivery

Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...

www.excelmale.com

ABSORPTION OF TESTOSTERONE CREAM VIA SCROTAL DELIVERY (2018)

ABSTRACT Transdermal testosterone has been used for years to treat patients with low testosterone symptoms. Clinically, we have monitored patients to evaluate results of testosterone absorption via blood serum concentrations. The data on multiple time points to determine trough and peak...

www.excelmale.com

Great advice

 

[Rclouviere]

Your best bet would be looking into a higher strength compounded T cream scrotal application which would allow one to easily overcome issues with absorption let alone hit high/very high T levels!

Otherwise I would try oral TU before moving on to injections.

Do what you feel is best for you!

Pharmacokinetics of testosterone cream applied to scrotal skin

Conclusion *we concluded that the scrotal administration of testosterone in a cream formulation provides high bioavailability, dose-dependant peak serum testosterone concentration, and tolerability with a much lower dose relative to the non-scrotal transdermal route *further studies of...

www.excelmale.com

Case Study: Absorption of Testosterone Cream via Scrotal Delivery

Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...

www.excelmale.com

ABSORPTION OF TESTOSTERONE CREAM VIA SCROTAL DELIVERY (2018)

ABSTRACT Transdermal testosterone has been used for years to treat patients with low testosterone symptoms. Clinically, we have monitored patients to evaluate results of testosterone absorption via blood serum concentrations. The data on multiple time points to determine trough and peak...

www.excelmale.com

Madman, you’ve been a great help with your posts. I’ll probabkybteybteatim before the oral route. Have you been using the oral versions? If so, what’s your take? And, how about the elevated psa numbers?

 

[Systemlord]

And, how about the elevated psa numbers?

PSA lab testing produces the most false positives for diseases. This is what the guy that created the PSA test had to say. There are many different reasons why PSA would be elevated, age, prostate cancer, urinary tract infection, and the list goes on and on.

So the key takeaway here is an elevated PSA can be harmless. For the record TRT, testosterone doesn't cause prostate cancer, low testosterone is a risk factor for more aggressive prostate cancer, and reoccurrence.

TRT has been shown to prevent or delay the onset of prostate cancer.

Men on TRT show a clear decreased risk of developing prostate cancer.

 

[Rclouviere]

PSA lab testing produces the most false positives for diseases. This is what the guy that created the PSA test had to say. There are many different reasons why PSA would be elevated, age, prostate cancer, urinary tract infection, and the list goes on and on.

So the key takeaway here is an elevated PSA can be harmless. For the record TRT, testosterone doesn't cause prostate cancer, low testosterone is a risk factor for more aggressive prostate cancer, and reoccurrence.

TRT has been shown to prevent or delay the onset of prostate cancer.

Men on TRT show a clear decreased risk of developing prostate cancer.

Thank you for the response. My psa has gone from 3.2 to 5.6. Doesn’t this possibly lead to an enlarged prostrate?

 

[Systemlord]

My psa has gone from 3.2 to 5.6. Doesn’t this possibly lead to an enlarged prostrate?

Yes, BPH can increase PSA.

 

[madman]

Madman, you’ve been a great help with your posts. I’ll probabkybteybteatim before the oral route. Have you been using the oral versions? If so, what’s your take? And, how about the elevated psa numbers?

No I have been using injectable T from the get-go (Dec. 24/2016).

I had started on Depo-Testosterone (TC) for the first 3 months then moved on to Delatestryl (TE) for 6 years before switching back to Depo-Testosterone (TC).

I have always injected strictly sub-q twice-weekly (every 3.5 days) mind you for the past year I have been following a 4/3 weekly injection protocol!

Could be numerous reasons for the elevated PSA and seeing it is >4 you need to have this looked into by a urologist to pinpoint why!

Listen closely to Dr. Khera reply as he lays it out when it comes to testosterone therapy and PSA!

Link Between Testosterone And The Prostate

*7:00-13:20 (DHT, estradiol, 5ARIs, AIs) On this episode of the Dr. Geo podcast, we have a special guest, Dr. Mohit Khera, a renowned urologist and professor in the Scott Department of Urology at Baylor College of Medicine. He holds the F. Brantley Scott Chair in Urology and has extensive...

www.excelmale.com

33:33 Testosterone…PSA will go up almost inevitably




Dr. Scholz explains what a normal PSA would be for a man that does not have prostate cancer!

3:15-6:09

post #13

Prostate Cancer Screening Blood Tests: OPKO 4K, PHI, & Free PSA

In the video, Dr. Marshalls, a medical oncologist with 30 years of experience in prostate cancer, discusses various blood tests used for prostate cancer screening. He explains the limitations of PSA (Prostate-Specific Antigen) tests, which can indicate issues with the prostate gland but are not...

www.excelmale.com

Trt options in men with BPH

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml. My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT...

www.excelmale.com

Is testosterone therapy dangerous for the prostate

The EAU Guidelines Office will provide a state-of-the-art update on male hypogonadism and testosterone replacement therapy. This recording will be of great educational value for urologists as internationally-known experts will focus on the controversial and challenging areas of this rapidly...

www.excelmale.com

Why Men Get an Enlarged Prostate and How to Treat BPH Symptoms

In this episode, Dr. Malik explains the causes of BPH, including hormonal, genetic, and inflammatory factors, and details its symptoms such as increased urinary frequency and urgency. She offers practical prevention tips like maintaining a healthy weight and active lifestyle, and reviews the...

www.excelmale.com

Testosterone Therapy Today: Clinical Advances & Safety with Dr. Abraham Morgentaler

Dr. Morgentaler back in action! Listen closely, loved this one! Pros/Cons oral TU (51:24-57:12) *one of the things that the orals have transformed is the concept that you have to have a continually high level of testosterone to get the benefits and clearly that's not true and the...

www.excelmale.com

Prostate Risk and Monitoring During TRT

ABSTRACT Men with hypogonadism have reduced risk of prostate cancer mortality; whether testosterone treatment increases the risk of prostate safety events in men with hypogonadism remains controversial. Several studies including four larger randomized trials — the Testosterone Trials...

www.excelmale.com

Prostate Safety Events During TRT in Men With Hypogonadism

Abstract IMPORTANCE The effect of testosterone replacement therapy (TRT) on the risk of prostate cancer and other adverse prostate events is unknown. OBJECTIVE To compare the effect of TRT vs placebo on the incidences of high-grade prostate cancers (Gleason score 4 + 3), any prostate...

www.excelmale.com

PSA Concentrations in Response to T Treatment of Severely Hypogonadal Men

Abstract Context: Clinical guidelines recommend measurement of the serum prostate-specific antigen (PSA) concentration during testosterone treatment of hypogonadal men to determine whether the increase is sufficiently high to warrant urologic referral. Prior studies of the effect of...

www.excelmale.com

EMAS position statement: TRT in older men

Introduction Late-onset hypogonadism is the clinical entity characterized by low testosterone concentrations associated with clinical symptoms in the absence of organic disease in aging men. It has been associated with metabolic syndrome, reduced bone mineral density, and increased...

www.excelmale.com

2.8. Prostate health and testosterone treatment

Recent data cast doubt on the dogma of Huggins and Hodges [142] regarding the dependence of CaP on androgens [143]. According to older population studies and a more recent meta-analysis, the incidence of CaP appears to be unrelated to endogenous T concentrations[144,145]. Men with CaP do not seem to have higher T concentrations than those without cancer; on the contrary, low T concentrations may predict more aggressive forms of CaP [146]. Moreover, CaP is more prevalent in older men, at ages when T concentrations decline. Similar conclusions may be drawn regarding TRT in men with hypogonadism,which does not appear to increase the incidence of CaP compared either to the general population (incidence <1 %) or to controls [odds ratio(OR) 0.97, 95 % CI 0.35 to 2.69] [38,109,144]. These findings align with the “prostate saturation” hypothesis, according to which when all androgen receptors of the prostate are saturated, a further increase in circulating T cannot affect the prostate gland [147].

Questions have been raised about whether CaP survivors with symptomatic hypogonadism can safely undergo TRT. Meta-analysing observational data from retrospective studies shows that TRT does not increase the risk of biochemical recurrence or progression of CaP after radical prostatectomy [148]. Similar results were obtained for patients treated with external beam radiation therapy, brachytherapy, cryotherapy, or high-intensity focused ultrasound, though the recurrence rate was higher compared with radical prostatectomy [149]. Patients whose initial assessment demonstrated a low-risk localised CaP (Gleason score <7, pT1–2, preoperative PSA <10 ng/ml) and who have constantly undetectable PSA concentrations after radical prostatectomy seem to have a lower risk of recurrence [143]. Nevertheless, it should be stressed that no RCTs have been conducted on this issue, rendering the level of evidence low and, thus, patients should be informed accordingly, give informed consent before TRT, and undergo close monitoring.

Concerns have also been expressed about the ability of TRT to augment prostate volume and to worsen lower urinary tract symptoms (LUTS); thus, men with severe LUTS, as defined by an International Prostate Symptom Score (IPPS) >19, are usually excluded from trials on TRT. Accordingly, TRT in this population is contraindicated in most guidelines. However, this recommendation is not based on high-quality evidence [150]. Meta-analysis of studies of TRT in men with pre-therapeutic mild LUTS did not show either a worsening of symptoms or an increase in prostate volume after treatment [151]. A recent trial that included hypogonadal men with metabolic syndrome and benign prostate hyperplasia showed that TRT can improve indices of prostate inflammation [152].




Summary recommendation

TRT may be considered in hypogonadal men with a history of previous low-risk, localised CaP (Gleason score <7, pT1–2, pre-operative PSA <10 ng/mL) who have constantly undetectable PSA concentrations after a radical prostatectomy; however, close monitoring is mandatory .TRT should not be avoided in men with hypogonadism and benign prostate hyperplasia/LUTS; however, caution should be paid to those with severe LUTS (IPSS >19).

 

[Rclouviere]

No I have been using injectable T from the get-go (Dec. 24/2016).

I had started on Depo-Testosterone (TC) for the first 3 months then moved on to Delatestryl (TE) for 6 years before switching back to Depo-Testosterone (TC).

I have always injected strictly sub-q twice-weekly (every 3.5 days) mind you for the past year I have been following a 4/3 weekly injection protocol!

Could be numerous reasons for the elevated PSA and seeing it is >4 you need to have this looked into by a urologist to pinpoint why!

Listen closely to Dr. Khera reply as he lays it out when it comes to testosterone therapy and PSA!

Link Between Testosterone And The Prostate

*7:00-13:20 (DHT, estradiol, 5ARIs, AIs) On this episode of the Dr. Geo podcast, we have a special guest, Dr. Mohit Khera, a renowned urologist and professor in the Scott Department of Urology at Baylor College of Medicine. He holds the F. Brantley Scott Chair in Urology and has extensive...

www.excelmale.com

33:33 Testosterone…PSA will go up almost inevitably




Dr. Scholz explains what a normal PSA would be for a man that does not have prostate cancer!

3:15-6:09

post #13

Prostate Cancer Screening Blood Tests: OPKO 4K, PHI, & Free PSA

In the video, Dr. Marshalls, a medical oncologist with 30 years of experience in prostate cancer, discusses various blood tests used for prostate cancer screening. He explains the limitations of PSA (Prostate-Specific Antigen) tests, which can indicate issues with the prostate gland but are not...

www.excelmale.com

Trt options in men with BPH

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml. My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT...

www.excelmale.com

Is testosterone therapy dangerous for the prostate

The EAU Guidelines Office will provide a state-of-the-art update on male hypogonadism and testosterone replacement therapy. This recording will be of great educational value for urologists as internationally-known experts will focus on the controversial and challenging areas of this rapidly...

www.excelmale.com

Why Men Get an Enlarged Prostate and How to Treat BPH Symptoms

In this episode, Dr. Malik explains the causes of BPH, including hormonal, genetic, and inflammatory factors, and details its symptoms such as increased urinary frequency and urgency. She offers practical prevention tips like maintaining a healthy weight and active lifestyle, and reviews the...

www.excelmale.com

Testosterone Therapy Today: Clinical Advances & Safety with Dr. Abraham Morgentaler

Dr. Morgentaler back in action! Listen closely, loved this one! Pros/Cons oral TU (51:24-57:12) *one of the things that the orals have transformed is the concept that you have to have a continually high level of testosterone to get the benefits and clearly that's not true and the...

www.excelmale.com

Prostate Risk and Monitoring During TRT

ABSTRACT Men with hypogonadism have reduced risk of prostate cancer mortality; whether testosterone treatment increases the risk of prostate safety events in men with hypogonadism remains controversial. Several studies including four larger randomized trials — the Testosterone Trials...

www.excelmale.com

Prostate Safety Events During TRT in Men With Hypogonadism

Abstract IMPORTANCE The effect of testosterone replacement therapy (TRT) on the risk of prostate cancer and other adverse prostate events is unknown. OBJECTIVE To compare the effect of TRT vs placebo on the incidences of high-grade prostate cancers (Gleason score 4 + 3), any prostate...

www.excelmale.com

PSA Concentrations in Response to T Treatment of Severely Hypogonadal Men

Abstract Context: Clinical guidelines recommend measurement of the serum prostate-specific antigen (PSA) concentration during testosterone treatment of hypogonadal men to determine whether the increase is sufficiently high to warrant urologic referral. Prior studies of the effect of...

www.excelmale.com

EMAS position statement: TRT in older men

Introduction Late-onset hypogonadism is the clinical entity characterized by low testosterone concentrations associated with clinical symptoms in the absence of organic disease in aging men. It has been associated with metabolic syndrome, reduced bone mineral density, and increased...

www.excelmale.com

2.8. Prostate health and testosterone treatment

Recent data cast doubt on the dogma of Huggins and Hodges [142] regarding the dependence of CaP on androgens [143]. According to older population studies and a more recent meta-analysis, the incidence of CaP appears to be unrelated to endogenous T concentrations[144,145]. Men with CaP do not seem to have higher T concentrations than those without cancer; on the contrary, low T concentrations may predict more aggressive forms of CaP [146]. Moreover, CaP is more prevalent in older men, at ages when T concentrations decline. Similar conclusions may be drawn regarding TRT in men with hypogonadism,which does not appear to increase the incidence of CaP compared either to the general population (incidence <1 %) or to controls [odds ratio(OR) 0.97, 95 % CI 0.35 to 2.69] [38,109,144]. These findings align with the “prostate saturation” hypothesis, according to which when all androgen receptors of the prostate are saturated, a further increase in circulating T cannot affect the prostate gland [147].

Questions have been raised about whether CaP survivors with symptomatic hypogonadism can safely undergo TRT. Meta-analysing observational data from retrospective studies shows that TRT does not increase the risk of biochemical recurrence or progression of CaP after radical prostatectomy [148]. Similar results were obtained for patients treated with external beam radiation therapy, brachytherapy, cryotherapy, or high-intensity focused ultrasound, though the recurrence rate was higher compared with radical prostatectomy [149]. Patients whose initial assessment demonstrated a low-risk localised CaP (Gleason score <7, pT1–2, preoperative PSA <10 ng/ml) and who have constantly undetectable PSA concentrations after radical prostatectomy seem to have a lower risk of recurrence [143]. Nevertheless, it should be stressed that no RCTs have been conducted on this issue, rendering the level of evidence low and, thus, patients should be informed accordingly, give informed consent before TRT, and undergo close monitoring.

Concerns have also been expressed about the ability of TRT to augment prostate volume and to worsen lower urinary tract symptoms (LUTS); thus, men with severe LUTS, as defined by an International Prostate Symptom Score (IPPS) >19, are usually excluded from trials on TRT. Accordingly, TRT in this population is contraindicated in most guidelines. However, this recommendation is not based on high-quality evidence [150]. Meta-analysis of studies of TRT in men with pre-therapeutic mild LUTS did not show either a worsening of symptoms or an increase in prostate volume after treatment [151]. A recent trial that included hypogonadal men with metabolic syndrome and benign prostate hyperplasia showed that TRT can improve indices of prostate inflammation [152].




Summary recommendation

TRT may be considered in hypogonadal men with a history of previous low-risk, localised CaP (Gleason score <7, pT1–2, pre-operative PSA <10 ng/mL) who have constantly undetectable PSA concentrations after a radical prostatectomy; however, close monitoring is mandatory .TRT should not be avoided in men with hypogonadism and benign prostate hyperplasia/LUTS; however, caution should be paid to those with severe LUTS (IPSS >19).

Went tomorrow. He was concerned with the increase in my psa. Weird since my tester one never went up while on it. Took me off androgen. Wants blood test in 3 weeks to see if osa goes down below 4.7. If not, he’ll send me to a urologist. Should i be concerned? Will it go back down?

 

[Rclouviere]

Went tomorrow. He was concerned with the increase in my psa. Weird since my tester one never went up while on it. Took me off androgen. Wants blood test in 3 weeks to see if osa goes down below 4.7. If not, he’ll send me to a urologist. Should i be concerned? Will it go back down?

Went “to doctor,” not “tomorrow”. typo