Starting on TRT Compound Cream and Joining the Forum

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A large thread on this.



Unknown. Guess what? The big pushers (touts) don't know either. FAAFO.

Have you figured it out @RobRoy? People are waiting....

 
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What are the potential side effects of running high DHT for extended time? I have never seen anything identified though I agree it would not seem like good idea.

@readalot posted some studies in this thread: Trans scrotal testosterone cream application is a game changer

There's an interesting back and forth between Dr Saya and @RobRoy, who I think was understood to be Dr Nichols.

This is the most comprehensive study I've seen on DHT (on or off TRT), I recommend reading it: Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

Essential Points​

  • Circulating levels of DHT in response to testosterone replacement therapy (TRT) do not correlate with those found in androgen sensitive tissue (e.g., prostate, adipose, muscle) due to local regulatory mechanisms that tightly control intracellular androgen homeostasis.
  • The modest increases observed in serum DHT and in the DHT/T ratio observed after TRT are unlikely to be a cause of clinical concern, particularly when viewed in the context of changes observed in these parameters for currently marketed T-replacement products and those under development for which DHT data are available.
  • While well-controlled, long-term studies designed to specifically examine the effects of androgen exposure on risk for prostate need to be conducted, the current clinical data base is relatively reassuring that circulating levels of androgens (or changes in such) apparently do not play as pivotal a role as once thought in the development of prostate disease.
  • Robust epidemiologic or clinical trial evidence of a deleterious DHT effect on CVD is lacking. There is some evidence that DHT therapy in men with CVD may improve clinical status—a finding that needs confirmation. Data from a longitudinal data base of older normal (i.e., not hypogonadal) indicated an association between serum DHT and incident CV disease and mortality. Conversely, others have reported that higher DHT levels in older men were associated with decreased all-cause mortality and reduced ischemic heart disease mortality. Additional exploration in prospective, placebo-controlled intervention studies of TRT with CVD as the primary endpoint is needed to resolve the long-term effects of androgens on CVD risks.
  • DHT does not play a substantive role in body composition compared to T under normal conditions. Thus, elevated levels of DHT in response to TRT are unlikely to appreciably impact lean or fat mass. Nonetheless, data from animals suggest a role for DHT in adipose tissue that inhibits biochemical pathways involved in lipid synthesis and promotes several transcripts associated with apoptosis of adipocytes. Whether these DHT-induced effects also occur in human adipose tissue remains an area for future study.
  • There is very limited data available regarding DHT and effects on cognition. Further research is needed, particularly in light of animal data where DHT positively modified synaptic structure and significantly delayed cognitive impairment in a well-regarded animal model for Alzheimer’s disease.
  • Recent data indicating that higher levels of DHT were inversely associated with insulin resistance and risk of diabetes merit further mechanistic investigation to understand whether this action is separate from that of T.

There was a study showing extremely elevated DHT levels (around 500+ ng/dL) for I think 24 months without negative side effects (along the specific markers and metrics they were keeping track of of course). However in that study Testosterone wasn't supplemented and therefore Test levels fell and were severely depressed throughout the study, so those findings don't necessarily represent what hyper-elevated DHT levels would do to someone on TRT long term.

In general negative side effects as a function of hormone levels follow a classic "u" curve, whereby too low or too high levels lead to dose-dependent increased negative sides. Just because there isn't research showing those negative side effects doesn't mean they won't happen.

At some point, in the absence of specific enough research I think common sense should prevail and to me, that means running DHT at 5-10x the range for a few decades is probably a bad idea
 
This is incorrect. In the paper I linked above there is a study on transdermal DHT applied for 24 months where end of treatment levels reached 733ng/dL, as well as other studies lasting from 3 to 24 months
If you consider 24 months long term, then we have a difference of opinion of what long term means.

Long term = occurring over or involving a relatively long period of time.
 
If you consider 24 months long term, then we have a difference of opinion of what long term means.

Long term = occurring over or involving a relatively long period of time.

Stop. When you wrote your initial comment you didn't consider 24 months to be short term.

But what about 8 years with end of treatment levels at 175ng/dL, almost 3x the top of the Quest range for DHT at 12-65 ng/dL?

Atkinson LE, Chang YL, Snyder PJ. Long-term experience with testosterone replacement through scrotal skin. In: Nieschlag EaBH, ed. Testosterone: Action, Deficiency and Subsititution. Berlin: Springer-Verlag; 1998:365–388

8 years also short term?
 




etc, etc, etc.
Context for definition is clinical trials.

 
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I didn't really get any answers and my intro post turned into people discussing sticking cream in thier ass. What an interesting forum.
Can you post a photo of the label.
I’m interested in knowing the doctor/clinic you use. I see people in new Zealand all the time on steroid forums searching for information and illegal testosterone.

I send them a link to this forum and hope they can do research.
 
Hy
Can you post a photo of the label.
I’m interested in knowing the doctor/clinic you use. I see people in new Zealand all the time on steroid forums searching for information and illegal testosterone.

I send them a link to this forum and hope they can do research
Hey, I can't post a label as it's got too much personal info all over it

What I will say is that injections is not a thing over here, they are not provided for trt. Injections you can get for a female to male transition, but if you are born a male and want to be a male you cannot get it

There are 2 that I know of, clinics that prescribe TRT, with both of them using Australian doctors who are licensed here in NZ too.

We have a compounding pharmacy in New Zealand, but ultimately you have to go to these private clinics.

If you take on TRT with the healthcare system, you will get nowhere.

If you've got any questions, I did a ton of research prior to going to one and starting the cream. Happy to answer anything that I know the answer too
 
Hy

Hey, I can't post a label as it's got too much personal info all over it

What I will say is that injections is not a thing over here, they are not provided for trt. Injections you can get for a female to male transition, but if you are born a male and want to be a male you cannot get it

There are 2 that I know of, clinics that prescribe TRT, with both of them using Australian doctors who are licensed here in NZ too.

We have a compounding pharmacy in New Zealand, but ultimately you have to go to these private clinics.

If you take on TRT with the healthcare system, you will get nowhere.

If you've got any questions, I did a ton of research prior to going to one and starting the cream. Happy to answer anything that I know the answer too
There is a clinic in Queensland Australia that is supposed to ship injectable testosterone to New Zealand. Could be they don’t and it’s your doctor that uses the compound pharmacy in New Zealand.

Australia is hard but if you know who prescribes you can get injections. One in Perth , Gold Coast and Melbourne that I know of.
How much do you pay a year for treatment ?
 
There is a clinic in Queensland Australia that is supposed to ship injectable testosterone to New Zealand. Could be they don’t and it’s your doctor that uses the compound pharmacy in New Zealand.

Australia is hard but if you know who prescribes you can get injections. One in Perth , Gold Coast and Melbourne that I know of.
How much do you pay a year for treatment ?
That's very interesting information.

I couldn't find much on what happens in Australia, so I find what you say really interesting.

I pay $2200 NZD per year for my treatment. That includes blood work, prescriptions and shipping etc. I am not sure what this is in AUD?

I would prefer injections, and underground stuff here is relatively easy to access. It would cost me $760 per year for injections if I went underground.

My issue with doing that is that I genuinely have hypogonadism, with rock bottom T levels, so I don't feel like I should have to break the law to get the medication I need, if that makes sense.

Who are these clinics if you don't mind me asking? Feel free to PM me if that's an option here, and if you'd like.
 
Beyond Testosterone Book by Nelson Vergel
From personal experience I would exercise extreme caution with DMSO and topical testosterone preparations. I originally was using a locally compounded product 10mg/gm applying 5 grams daily. My doctor was not satisfied with the blood levels so he doubled the strength to 20mg/gm, same 5 grams daily. This got me up in the 900s. This was before the lab ranges were dropped. Ten grams of the 10mg/gm was just too much volume, you had it everywhere. I got to reading about DMSO increasing absorption. That's definitely a fact. When I added some DMSO to the palm of my hand along with the 2% cream and rubbed it on in the same manner I got the same result from 1 gram with the DMSO as I did with 5 grams without. Was a huge cost benefit. Several months after starting this I started applying a DHEA/Pregnenolone solution in a base of alcohol/DMSO on the opposite shoulder and would alternate shoulders daily. This was not a problem because DMSO was on both shoulders. What got me into trouble was when the MD decided he wanted to try a commercial product, Testim to see if we could get more consistency. Since I had met my deductible I agreed. What I didn't realize is the DHEA/Pregnenolone solution I was applying to the opposite shoulder and alternating was leaving some residual DMSO in the skin so when the Testim was applied on that shoulder the next day absorption skyrocketed. I never thought about residual activity. Testosterone went up to >1900, spiked my estrogen levels which created a cascade of clotting activity and I landed in the hospital with pulmonary emboli. I am going to expand on the coagulation topic in another post but bottom line is be extremely careful. I would guess only a small percentage of those on trt had a hypercoagulation panel done prior to beginning. That underlying and unknown condition is what made the estrogen spike more dangerous.
 
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