Anyone combine injections and cream? How do you feel?

[engineer]

Once again, it's great that HC works for you. That said, no one can provide an explanation as to your stuff without more information. I'd suggest starting a new thread of your own with bloodwork, relevant medical history, what interventions you've described, etc. I am still not sure what you're asking of me in response to my comment about my diurnal cortisol rhythm, but I am confident that at this point you'll want your own thread to be able to share info and get more helpful responses. As an example, testosterone can interfere with the HPA axis and maybe your "high" testosterone levels are too high FOR YOU. Without knowing baseline levels, what protocols you've tried, etc, no one can help you. Start your thread and see what happens!

You are right, I will gather my previous protocols with lab work and start my own thread. I only asked you here because it was the first time that I read about a relationship between Testosterone levels with Cortisol levels. Until now, I was taking my medications but always thinking "what's causing this???" and like you said, it could very well be that my test levels are too high FOR ME.

Thanks again for your reply!

 

[eyeheartny]

You are right, I will gather my previous protocols with lab work and start my own thread. I only asked you here because it was the first time that I read about a relationship between Testosterone levels with Cortisol levels. Until now, I was taking my medications but always thinking "what's causing this???" and like you said, it could very well be that my test levels are too high FOR ME.

Thanks again for your reply!

It took a fair bit of research to determine this, but there's a strong correlation between testosterone and inhibition of ACTH, which is what causes your body to release cortisol. It's very very possible that your body is especially sensitive to testosterone's effects on the HPA axis and that you get too much inhibition of ACTH. I also looked at your post history and discovered that you had been using Oxandrolone. If you are still using that, I'd also look at that as a potential culprit for your fatigue. Oxandrolone can lower SHBG levels DRAMATICALLY, which causes your free testosterone to be higher, which can be interfering with your HPA axis and inhibiting cortisol release.

I also noticed that you indicated you'd needed to use AIs in the past. There is a school of thought with TRT that if you respond positively to AIs, you should lower your dose until you get to a point where you don't need to use an AI to manage those symptoms. Your body's testosterone set point may be well be lower than what you are dosing yourself at. The combination of "needing" to use an AI plus the HPA inhibition from testosterone says to me that you may just be using too much testosterone. Certainly worth discussing with your doctor, but in my experience Defy went way off the rails and tends to overprescribe and overdose.

 

[engineer]

wow, thanks a lot for your response. You went above and beyond what I was expecting.... Just to clarify a few things and confirm what you found in previous posts:

1) I am used to use a low dose of AI from the get go from Defy:
- 70mg Test - twice per week
- Some HCG which I stopped due to anxiety
- 0.25mg of Anastrozole twice per week

2) Dr. Saya added Oxandrolone to my protocol (due to a waste condition on my leg cause by a spine injury) and with that, the use of an AI became less and less necessary

3) We switched my protocol to Tcream and I stopped aromatizing at the time. Blamed on the cream and went back to injections but I was still not aromatizing. With that, Defy kept increasing my dose in the hopes my E2 would catch up but never did. Was even prescribed an E2 cream to alleviate the symptoms of low E2.

4) Today I know that the cause was the Oxandrolone (DHT) because we decided to exchange that to Nandrolone (cheaper option) and I started to produce E2 again. But then, at this point, I was taking 280mg/week of Test (and since my SHBG was in the gutter like you predicted, I turned to daily injections-30mg/day).

5) At this point, the sleepiness was already in and unbearable but I didn't know the reason. On my own, I decreased my Test over time to 20mg/day and felt a lot better (but Free T very high still). However, again (like you mentioned....), Defy increased it to 24mg/day without much of a reason. I take no AI but still am facing ED problems...

The sleepiness was debilitating to my job.... hydrocortisone took care of that but now I am pretty confident that with LESS testosterone, I may not even need it. AND it may be key to get rid of lingering symptoms that I still have.

Man, thanks so much for your time. I had all this info but couldn't put it together in a way that offered me a path forward. I appreciate the help!

 

[Cataceous]

It took a fair bit of research to determine this, but there's a strong correlation between testosterone and inhibition of ACTH, which is what causes your body to release cortisol. ...

I wanted to read more and found this work. What really caught my attention is the following line, which I will undoubtedly be citing a lot in the future:

Because circulating T normally fluctuates over a diurnal rhythm, delivery of T in a manner that mimics this diurnal rhythm may be more effective in suppressing stress-related HPA activity than constant levels of T replacement would be.​

 

[gerardo]

I wanted to read more and found this work. What really caught my attention is the following line, which I will undoubtedly be citing a lot in the future:

Because circulating T normally fluctuates over a diurnal rhythm, delivery of T in a manner that mimics this diurnal rhythm may be more effective in suppressing stress-related HPA activity than constant levels of T replacement would be.​

I understand that You mean that the daytime variation suppresses the HPA less and that The more stable TT levels suppress the HPA more. That's it? Did you get to see what the minimum daily dose of a cypionate would be that would keep the HPA working?

 

[Cataceous]

I understand that You mean that the daytime variation suppresses the HPA less and that The more stable TT levels suppress the HPA more. That's it? Did you get to see what the minimum daily dose of a cypionate would be that would keep the HPA working?

I haven't studied the subject enough to make specific claims. But I will use the statement to illustrate that a steady physiological level of testosterone can cause different HPA effects compared to when there is diurnal variation.

 

[Fortunate]

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.

Great feedback and a lesson for us all, I think. Are you still on TRT? If so, what is your current protocol?

 

[Gianluca]

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.

Curious to know your DHT and E2 level with the 1 click transcrotal cream

 

[BUD987]

@Cataceous and all -- old thread but what are your thoughts on the PK and PD differences between test Prop and scrotum cream? Effective half life, aromatization, Central gonadotrope suppression. I know cream generates more DHT due to 5ar in scrotum skin. Asking bcs i find cream timing a bit of a hassle at times. My schedule isnt that regular -- So Im asking the questions constantly of well if I put it on before showering how long to wait, how much really getting in, working out timing, dressing and sex timing -- its just more on the brain than I want. Would prefer a daily injection and be done.
I like the above protocol of low dose daily hcg and low dose short half life T . Feels best and makes most sense.

I am just on 100iu hcg qd now and recent levels are TT 598, FT 133, SHBG 30, but E2 sens 47. LH 3.3 [not totally shut down], DHT high normal.

Feel the high E2 - tight urinary stream, water retention, still hard to build muscle, flabbier, libido meh, EQ meh but better than straight TC or TE.

Thought with Dr S was to add super low dose cream 3.25mg cream to boost T to high normal and cut E2 a little plus boost DHT. I have to take a lot of Anastrozole to sortof manage E on HCG about 0.5-0.7 mg a wk [compounded 0.1mg daily].

Would prefer to sub the Cream for TP + 50-100iu HCG qd. But not sure how it will differ or if difference will be significant.

ALSO with HCg you can see LH still not totally shut down so its unclear how much of my TT/FT is from hcg stim vs still sorta active HPTA. With addition of cream or low dose TP I should expect more HPTA shut down. Plan to compensate?

Lots here -- random post -- can DM if easier or make my own post

 

[BUD987]

Also been looking but can’t get solid evidence on how much of t cream to scrotum is thought to be absorbed. Ie 3.25mg t containing cream to scrotum what % of that 3.25mg is thought to reach systemic circ? 20%? Trying to compare injection with water compensation vs cream