Tread lightly with 200 mg/ml Testosterone Cream . . . My experience

[VacationMan]

DRE

It was part of my usual 6-month full hormone panel blood work. Yes, I did have a DRE as a part of the office visit. Even at 57, I've never had any type of prostate issue (knock on wood).

I seriously doubt it was a false positive. Been on TRT for more than 5 years, with full blood work every 6 months to monitor. Over all that time, my labs showed consistent PSA ranging between 1.4 to 1.7 every time. We added DHT to the list of labs about 18 months ago and it was noted that DHT was at the lower end of the range, so I started the scrotal T application - just one application (1 click) per day (50 mg/ml mix). Next 6-month series of blood work showed DHT in range but also showed elevated PSA at 3.9. Too close for comfort, so I stopped the scrotal T application. Next 6-month blood work showed PSA at a very acceptable level of 1.4.

Everyone's body chemistry is different. If it works for you, great - but do be sure to monitor PSA if you choose to take on this protocol.

 

[tropicaldaze1950]

Listening to Dr. Nicholson on Jay Campbell, he said that the PSA will spike but over time, it will lower. I'm not on T cream but thinking of asking my urologist if we should try this instead of injections, which have yet to restore erectile function.

 

[Gunga]

Update on protocol and physician change. . . . I had a phenomenal consult with Dr Saya 12-14-19! Finally a doctor that knows his craft and communicates his knowledge extremely well! He was incredibly patient as I grilled him with a number of questions covering symptom resolution, peptides, otc supplements, etc. i got a clear feeling that he’s seen my specific situation many times and had a plan of attack to get me on the right path. I’ve not felt this well in years. We decided to go back to daily Test Cyp injections of 14mgs daily and Armidex .125 EOD as well. Im a high estrogen converter. I also started low dose DHEA 10 mgs as my levels were brutally low. Have labs in a few months but I can tell already by how I feel I’m on the right track. We will look at DHT levels at next labs to see if adding a small lower dose cream dose would be worth doing. I’d pay double to work with a specialist such as this. This is intricate science and you need a pro. If your looking for a physician stop thinking and call Dr Saya at Defy Medical.

 

[Dr Justin Saya MD]

Update on protocol and physician change. . . . I had a phenomenal consult with Dr Saya 12-14-19! Finally a doctor that knows his craft and communicates his knowledge extremely well! He was incredibly patient as I grilled him with a number of questions covering symptom resolution, peptides, otc supplements, etc. i got a clear feeling that he’s seen my specific situation many times and had a plan of attack to get me on the right path. I’ve not felt this well in years. We decided to go back to daily Test Cyp injections of 14mgs daily and Armidex .125 EOD as well. Im a high estrogen converter. I also started low dose DHEA 10 mgs as my levels were brutally low. Have labs in a few months but I can tell already by how I feel I’m on the right track. We will look at DHT levels at next labs to see if adding a small lower dose cream dose would be worth doing. I’d pay double to work with a specialist such as this. This is intricate science and you need a pro. If your looking for a physician stop thinking and call Dr Saya at Defy Medical.

Appreciate your kind words Gunga

 

[meelord]

Update on protocol and physician change. . . . I had a phenomenal consult with Dr Saya 12-14-19! Finally a doctor that knows his craft and communicates his knowledge extremely well! He was incredibly patient as I grilled him with a number of questions covering symptom resolution, peptides, otc supplements, etc. i got a clear feeling that he’s seen my specific situation many times and had a plan of attack to get me on the right path. I’ve not felt this well in years. We decided to go back to daily Test Cyp injections of 14mgs daily and Armidex .125 EOD as well. Im a high estrogen converter. I also started low dose DHEA 10 mgs as my levels were brutally low. Have labs in a few months but I can tell already by how I feel I’m on the right track. We will look at DHT levels at next labs to see if adding a small lower dose cream dose would be worth doing. I’d pay double to work with a specialist such as this. This is intricate science and you need a pro. If your looking for a physician stop thinking and call Dr Saya at Defy Medical.

I had the exact same experience with the t cream on the scrotum at half your dose. DHT was 480 and had t levels of 1300 to 1600...crazy. Just switched to Defy and am on twice weekly injections of T and HCG. Already feel better.

 

[Gman86]

@Dr Justin Saya MD Can I just get a quick yes or no answer from you, if you don’t mind. Don’t want to take up any of your time, but just very curious on your opinion. You don’t need to go into detail, or even explain your answer. Just a simple yes or no will suffice

Do you currently feel that in some instances E2 should be controlled, via a.i.’s, for one example. Or do you think, like some doctors recently, that E2 should only be controlled by adjusting the testosterone dosage up or down? Thanks.

 

[meelord]

@Dr Justin Saya MD Can I just get a quick yes or no answer from you, if you don’t mind. Don’t want to take up any of your time, but just very curious on your opinion. You don’t need to go into detail, or even explain your answer. Just a simple yes or no will suffice

Do you currently feel that in some instances E2 should be controlled, via a.i.’s, for one example. Or do you think, like some doctors recently, that E2 should only be controlled by adjusting the testosterone dosage up or down? Thanks.

My two cents: first try dosage of T but have AI available if needed.

 

[Dr Justin Saya MD]

@Dr Justin Saya MD Can I just get a quick yes or no answer from you, if you don’t mind. Don’t want to take up any of your time, but just very curious on your opinion. You don’t need to go into detail, or even explain your answer. Just a simple yes or no will suffice

Do you currently feel that in some instances E2 should be controlled, via a.i.’s, for one example. Or do you think, like some doctors recently, that E2 should only be controlled by adjusting the testosterone dosage up or down? Thanks.

The problem is that E2 does not follow T in an equal/identical fashion in all men. In other words, some men have higher aromatization than others. Additionally, some men seem more clinically sensitive to E2 (as levels rise) than others. Thus, my answer is yes - some men do need to pump the brakes a bit on that aromatization. Pump the brakes...not hit the emergency brake! True lowering T will lower E2, but for folks with higher aromatization rates that exhibit symptoms, they may need to drop their T below therapeutic (or optimal) to drop E2 enough to mitigate those symptoms.

A word to the wise - we can VERY rarely ever speak in absolutes when it comes to hormones. Consequently, resist any urges to do same and be wary of anyone who does.

 

[Charliebizz]

The problem is that E2 does not follow T in an equal/identical fashion in all men. In other words, some men have higher aromatization than others. Additionally, some men seem more clinically sensitive to E2 (as levels rise) than others. Thus, my answer is yes - some men do need to pump the brakes a bit on that aromatization. Pump the brakes...not hit the emergency brake! True lowering T will lower E2, but for folks with higher aromatization rates that exhibit symptoms, they may need to drop their T below therapeutic (or optimal) to drop E2 enough to mitigate those symptoms.

A word to the wise - we can VERY rarely ever speak in absolutes when it comes to hormones. Consequently, resist any urges to do same and be wary of anyone who does.

amen doc ive been saying that forever about absolutes in trt/hrt.

 

[Gman86]

The problem is that E2 does not follow T in an equal/identical fashion in all men. In other words, some men have higher aromatization than others. Additionally, some men seem more clinically sensitive to E2 (as levels rise) than others. Thus, my answer is yes - some men do need to pump the brakes a bit on that aromatization. Pump the brakes...not hit the emergency brake! True lowering T will lower E2, but for folks with higher aromatization rates that exhibit symptoms, they may need to drop their T below therapeutic (or optimal) to drop E2 enough to mitigate those symptoms.

A word to the wise - we can VERY rarely ever speak in absolutes when it comes to hormones. Consequently, resist any urges to do same and be wary of anyone who does.

Spoken like a true wise man lol. Couldn’t agree more with everything that you just said. You are the perfect balance of intelligence, rationality, common sense and curiosity. We’re extremely lucky to have you. Wish you had time for a YouTube channel and/ or podcast. I would literally pay a subscription fee, if I had to. And I can’t say that about any other YouTube channel or podcast that I can think of.

 

[Gunga]

The problem is that E2 does not follow T in an equal/identical fashion in all men. In other words, some men have higher aromatization than others. Additionally, some men seem more clinically sensitive to E2 (as levels rise) than others. Thus, my answer is yes - some men do need to pump the brakes a bit on that aromatization. Pump the brakes...not hit the emergency brake! True lowering T will lower E2, but for folks with higher aromatization rates that exhibit symptoms, they may need to drop their T below therapeutic (or optimal) to drop E2 enough to mitigate those symptoms.

A word to the wise - we can VERY rarely ever speak in absolutes when it comes to hormones. Consequently, resist any urges to do same and be wary of anyone who does.

Hallelujah!!!

It took me a while to realize I aromatize A LOT!!!
Whether it’s my 28% body fat or weekend bourbon habit as the cause, I realize now the excess estrogen WAS blocking the effects of Testosterone for me. I’ve lost 8lbs in a month with no real change to diet and exercise. Sexual function is better than ever. I’m hoping with continued loss of visceral body fat and reducing alcohol and cleansing liver, I’ll be able to reduce or drop AI some day.

Much appreciated Dr Saya!!!

 

[Riz747]

What I find interesting is the difference in "mg's per dose" dosages and how they relate to "T" levels in the body. Each person metabolizes drugs differently. I have one of those metabolisms that simply "eat up" whatever I am taking. I process fast (and yes, I have my Liver and Kidney functions tested twice a year and they are normal). I went from a commercial topical (Androgel) to a custom compound topical about 9 years ago. Now get this... I dose at 70mg/dose BID AM and PM. Yep, I take about 140mg of T daily. My levels hover anywhere from 900-1,100 ng/dl though one time I tested so high that LabCorp simply didn't have scale that went that high... They picked up residue from my inner arm when they took the blood sample. I apply this at 7 "drops" (imprecise) on my fore arm in the morning and at night. I rub both forearms together till absorbed. I'd prefer this in a Pentravan Plus vehicle but my Doc doesn't know how to write that Rx and convert what he Rx's from liquid to a cream (I gave him the original formula that was given to me by one of my customer's who is a dermatologist, 10 years ago). The current liquid vehicle leaves a residue and separates to easily. it requires VIGOROUS shaking to put it back into suspension. Pentravan Plus has a super high percutaneous absorption rate. One of these days I will get the pharmacist and my Doc on the phone together and get this changed.

Back on point: I take a very large dose and my levels are pretty normal. I'm 57 years old and had T levels, in my mid 40's below 20 ng/dl. I have no side effects. I'm doing pretty good on this dose. YMMV on what you do. it is all so dependent on how our body's process different topicals. I just find this all so interesting.

 

[JA Battle]

200mg cream is pretty stout I only use 50mg/mL and then its just 1 click or 12.5mg twice per day to the scrotum which supplements my 10mg/D Cyp.

nice this is what i would like to try combo of cyp to keep baseline around 500ish then am only cream to reflect a more natural pattern to not have chronically suppressed cortisol and thyroid. thyroid and adrenals need a chance to secrete. chronically high test especially with ppl frequent dosing doesnt allow for the other synergistic hormones to work.

 

[Charliebizz]

nice this is what i would like to try combo of cyp to keep baseline around 500ish then am only cream to reflect a more natural pattern to not have chronically suppressed cortisol and thyroid. thyroid and adrenals need a chance to secrete. chronically high test especially with ppl frequent dosing doesnt allow for the other synergistic hormones to work.

I’m no guru here but I’m not sure that is going to make a big difference. Your still suppressing your natural production. And your still going to have more stable levels then natural. But it’s worth a shot let me know how it goes. I’m one of those guys trt def hurts my cortisol levels.

I’m actually jumping back on. I have to find a way to make it work for me. I’m very interested in cream but I don’t think I’ll be very happy doing it 2x a day especially in summer months. With swimming and sweating. Trt is rough for a low shbg guy with low normal cortisol. But I just got my lowest natural reading yet. 160 total and man I feel it so gotta do something

 

[JA Battle]

I’m no guru here but I’m not sure that is going to make a big difference. Your still suppressing your natural production. And your still going to have more stable levels then natural. But it’s worth a shot let me know how it goes. I’m one of those guys trt def hurts my cortisol levels.

I’m actually jumping back on. I have to find a way to make it work for me. I’m very interested in cream but I don’t think I’ll be very happy doing it 2x a day especially in summer months. With swimming and sweating. Trt is rough for a low shbg guy with low normal cortisol. But I just got my lowest natural reading yet. 160 total and man I feel it so gotta do something

i gotcha man good luck with that,

actually the funny part of my post was that im striving to not have stable levels. i want mid 500s when i wake up early and then use topical cream early in morning to boost levels to around 900-1000ish (whatever feels right) by mid morning and then the steady decline back to 500 the next morning. this is suppose to in theory replicate the natural pattern testosterone follows in healthy young males. Lots of variables i know. but honestly is not a hard protocol to try. I saw that a member vince carter does something similar if i am correct.

and best of luck man, so many ways to skin a cat but ultimately there is a best way for everyone. thanks for your feedback brother!

 

[Charliebizz]

i gotcha man good luck with that,

actually the funny part of my post was that im striving to not have stable levels. i want mid 500s when i wake up early and then use topical cream early in morning to boost levels to around 900-1000ish (whatever feels right) by mid morning and then the steady decline back to 500 the next morning. this is suppose to in theory replicate the natural pattern testosterone follows in healthy young males. Lots of variables i know. but honestly is not a hard protocol to try. I saw that a member vince carter does something similar if i am correct.

and best of luck man, so many ways to skin a cat but ultimately there is a best way for everyone. thanks for your feedback brother!

i get what your saying I meant it like even the low dose of cyp might keep your levels stable to a degree. I wish we knew what the real mechanism is too why some guys other hormones get messed up from trt while some others don’t move much.

I agree with you 100% we are all different and what works for one won’t work for another. Hope this works for you.

 

[JA Battle]

i get what your saying I meant it like even the low dose of cyp might keep your levels stable to a degree. I wish we knew what the real mechanism is too why some guys other hormones get messed up from trt while some others don’t move much.

I agree with you 100% we are all different and what works for one won’t work for another. Hope this works for you.

thanks man! good luck with the low shgb also. ive been learning about that struggle as so many guys are combating it on here.

 

[Testingmytesticles]

Hey,

just curious, what has been in your opinion the reason for most men on TRT getting body acne back/chest?

I got acne in HS, and it came back with a vengeance.

I was 200mg a week no HCG no AI, about 3rd month in it hit, I’m on 100mg now 50mg 2x a week no HCG no AI. I feel great bloods are good. My E2 hovers on the high side 30-40. Free is 800-1000.
I’m considering taking Accutane like I did in HS (worked great) but I’m wondering if it might be high E2.
Thinking of trying .25 anastrozole 1x or 2x Week.
One thing I noticed when I cut back from 200 to 100 I got about 30% less acne (still bad) and lost about 5 pounds in water weight. I’m still getting stronger in gym so no complaints. Also when I was on 200mg (100mg 2x a week) on day on injection I would get 3-5x white heads a couple hours later.

so I’m convinced it’s hormonal.

The problem is that E2 does not follow T in an equal/identical fashion in all men. In other words, some men have higher aromatization than others. Additionally, some men seem more clinically sensitive to E2 (as levels rise) than others. Thus, my answer is yes - some men do need to pump the brakes a bit on that aromatization. Pump the brakes...not hit the emergency brake! True lowering T will lower E2, but for folks with higher aromatization rates that exhibit symptoms, they may need to drop their T below therapeutic (or optimal) to drop E2 enough to mitigate those symptoms.

A word to the wise - we can VERY rarely ever speak in absolutes when it comes to hormones. Consequently, resist any urges to do same and be wary of anyone who does.

 

[JA Battle]

Hey,

just curious, what has been in your opinion the reason for most men on TRT getting body acne back/chest?

I got acne in HS, and it came back with a vengeance.

I was 200mg a week no HCG no AI, about 3rd month in it hit, I’m on 100mg now 50mg 2x a week no HCG no AI. I feel great bloods are good. My E2 hovers on the high side 30-40. Free is 800-1000.
I’m considering taking Accutane like I did in HS (worked great) but I’m wondering if it might be high E2.
Thinking of trying .25 anastrozole 1x or 2x Week.
One thing I noticed when I cut back from 200 to 100 I got about 30% less acne (still bad) and lost about 5 pounds in water weight. I’m still getting stronger in gym so no complaints. Also when I was on 200mg (100mg 2x a week) on day on injection I would get 3-5x white heads a couple hours later.

so I’m convinced it’s hormonal.

i would under no circumstances use accutane. it is essentially a vitamin a derivative that the body can barely metabolize. whole groups of people suffer serious metabolic consequences and a quick google search readily shows this.

i do not have a definite answer to your problem though. I had severe cystic acne well into my 20's. what helped me most was to deplete my body of pufa's. i believe progesterone may help significantly too. it opposes estrogen and is usually present in a healthy metabolism. these two things were huge for me. im on 200mg test c per week with eod regime currently and havent had a pimple. i was worried but it just hasnt shown up. i think frequent dosing is important too for those prone to acne. less highs and lows and allows whatever it is that is the issue from getting piled on at once.

what is your shgb?