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Dim3nsion

New Member
Morning Gents,

So I have been running Empower RX Compound cream for I guess a little over a year now Id say. Mine is 200mg/ml and I just do one click. From my understanding absorption was only around 10%, but pharmacist today said you absorb most of it? Thoughts? All the time I thought I'd be taking in around 5-7mg or so, but maybe I get closer to 50mg?

Reason for this post is I got lab work done for my annual checkup yest and my Total Test came back at 1500, which is too high for me. They didn't include free like I asked, so I will have to go back for that as total is useless. Heart problems run in the family and I just dont want to have my levels running that high. Cant say I've noticed any issues or sides, but to be safe. One question is should I not have applied the cream before testing. I'd say it was applied maybe an hour before and I also mostly switched to applying to bottom of scrotum, sometimes I alternate, but mainly applied there for the past few months.

Looking back at January labs I was lower. Total was 404, this was done later in the afternoon, so could be why. Again I'd rather be around 750-800 and seeing that 1500 worries me as that is too high to consistently be at. I dont need problems like my dad had with prostate, heart, ect. My urologist isn't very helpful and basically goes on whatever I want him prescribing me. At first he said injectable, then I said no I wanted compound cream to maintain stability and avoid peaks and valleys. Would you think I should possibly ask to get another formulation at 100mg/ml and just run 1 click which would give me 25mg.

Thanks for any info/help you can provide!
 

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Cataceous

Super Moderator
Regarding absorption, the pharmacist doesn't know what he's talking about. On normal skin it is about 10%. On scrotal skin it's probably anywhere from 10-60%.

Don't bother with a standard direct free T test. A test that gives you SHBG and total T—and ideally albumin too—is ok because you can use a calculator to get a pretty accurate estimate of free testosterone. Otherwise you're left with getting one of the expensive tests using equilibrium dialysis or ultrafiltration.

Injecting testosterone cypionate every other day would give you very stable serum testosterone, more so than transdermals, for better or for worse. Some find that a combination is the best: regular injections along with occasional low doses of cream on the scrotum.
 

Systemlord

Member
At first he said injectable, then I said no I wanted compound cream to maintain stability and avoid peaks and valleys.

This statement suggests your urologist is blindly following outdated guidelines, 200mg every two weeks which only causes peaks and valleys creating estrogen dominance in men while men are hypogonadal for the second week.

Clinical study on 200mg every 2 weeks --->Figure 1 graph B

When on TRT I inject T everyday, there are no peaks and valleys.
 
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Dim3nsion

New Member
Regarding absorption, the pharmacist doesn't know what he's talking about. On normal skin it is about 10%. On scrotal skin it's probably anywhere from 10-60%.

Thanks for the reply

Don't bother with a standard direct free T test. A test that gives you SHBG and total T—and ideally albumin too—is ok because you can use a calculator to get a pretty accurate estimate of free testosterone. Otherwise you're left with getting one of the expensive tests using equilibrium dialysis or ultrafiltration.

Injecting testosterone cypionate every other day would give you very stable serum testosterone, more so than transdermals, for better or for worse. Some find that a combination is the best: regular injections along with occasional low doses of cream on the scrotum.


Yeah, thats about what I thought was 10%. I feel like since I've switched strictly to scrotum, that it is absorbing better, so that would make sense.

Gotcha, I'll make a not of that for when I retest.

Hmm ok. Not really looking to go the injectable route. Figured I'd be able to run cream via scrotum or something daily and keep the levels steady enough. Thought I read it was best way to keep it stable as it mimics natural production more closely, but maybe that isn't true.

Do you think me applying an hour before testing would've been the result of such high total? Maybe I'll get it another formulation and try just going the 25mg application to scrotum daily and see how that works. I always responded very well to injectables in my days of running mild cycles, so maybe I just dont need as much.
 

Dim3nsion

New Member
This statement suggests your urologist is blindly following outdated guidelines, 200mg every two weeks which only causes peaks and valleys creating estrogen dominance in men while men are hypogonadal for the second week.

When on TRT I inject T everyday, there are no peaks and valleys.


Right he isn't really up on all of that, or knowledgeable in that regard. I told him I'd rather do EOD or something like that if I was going to do injectable and he was fine with it. But again I wanted to stick with the cream route as I respond well enough to it I feel like. Obviously I need to find someone more knowledgeable to work with, but it can be tough to find someone to prescribe it. My levels were around the low 400s or high 300s not being on it and most everyone else I talked to said it was in range, so wouldn't do anything.
 

Systemlord

Member
You're probably not going to find a knowledgeable doctor within the sick care system because hormones therapies are about optimizing your health, the sick care system for which your doctor is apart of is by design a sick care system, it doesn't optimize your health, it waits for disease to strike and then offers treatment.

If you want to optimise your state of health, then you need seek an anti-aging doctor outside of the sick care system.
 

Dim3nsion

New Member
You're probably not going to find a knowledgeable doctor within the sick care system because hormones therapies are about optimizing your health, the sick care system for which your doctor is apart of is by design a sick care system, it doesn't optimize your health, it waits for disease to strike and then offers treatment.

If you want to optimise your state of health, then you need seek an anti-aging doctor outside of the sick care system.


They have one of those at the urology place I goto. Just wasn’t sure about it as I don’t want them requiring me to come in constantly or end up costing way more. With him I can easily get what I want without much of any trouble. Maybe I’ll try his partner who is in the men’s clinic out and see what they say. Least I assume that’s what it is as they specialize in that.
 
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Timing of tests on topicals is the opposite of injections, it just is, that's a fact...you need to apply it about 2-3hrs prior and never have blood drawn on the arm you applied it to, if applied to an arm. You can' pull labs at different times of the day and then wonder why your numbers from one time to the next are so out of whack. A set time to apply, a set time to have blood work, is how you get to be able to compare labs side-by-side.

One lick of the dispenser in a typical clicker would be 1/4ml, or 50mg.
 

Dim3nsion

New Member
You spikes your levels before the test. Go get another one right before application time.

Your concerns around a number on a lab test and heart problems, etc are unfounded imo. Worrying about nothing.

If you feel good on your protocol you want to do a lipid and metabolic panel. See where things are trending. Include rbc and hematocrit.

Low T is unhealthy. 700 is. It a magic number. Neither is 1500. Anything in there is TRT in my book and should IMPROVE health and quality of life.

Something not often covered is AVERAGE levels across the half life. Your peak and trough are same day on the cream. Spiking to 1800 to end at 900 for example in a day doesn’t sound unreasonable. Same thing for injection 200 once a week. Possibly same values over 7 days.

Anecdotally blood work I’ve seen posted and had myself it was the total amount of circulating T/E over the time between application that moved things like HDL one direction over another.

In other words don’t fall into the trap of putting heavy stock in the numbers. It’s stupid and leads to lots of bad decisions and advice.


True, just so many heart issues in the family that I tend to worry. Plus I had a CAC scan done and it came back 45, which should be 0 at my age. Anyhow just have to keep up on exercise and eat healthy most times.

Attached is my CBC labs, which include Hematocrit and RBC
 

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Dim3nsion

New Member
Timing of tests on topicals is the opposite of injections, it just is, that's a fact...you need to apply it about 2-3hrs prior and never have blood drawn on the arm you applied it to, if applied to an arm. You can' pull labs at different times of the day and then wonder why your numbers from one time to the next are so out of whack. A set time to apply, a set time to have blood work, is how you get to be able to compare labs side-by-side.

One lick of the dispenser in a typical clicker would be 1/4ml, or 50mg.

It was applied scrotum, so arm wouldnt have mattered there. Labs were def pulled too soon that morning, didnt think about it and I needed other labs done anyhow for my annual. Thanks for the info.
 

Dim3nsion

New Member
True, just so many heart issues in the family that I tend to worry. Plus I had a CAC scan done and it came back 45, which should be 0 at my age. Anyhow just have to keep up on exercise and eat healthy most times.

Attached is my CBC labs, which include Hematocrit and RBC

Which to me they seem a little high, but they were already close to that before I even started TRT. I'll see what my Dr says about them, but I feel last time they said it wasnt a concern and those were fine.

I also attached labs on CBC from last year, which Hematocrit has went up some along with RBC. These were done at diff labs.
 

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