Trans scrotal testosterone cream application is a game changer

[Dr Justin Saya MD]

I read the article when originally published years ago. If you find a long term study of men with DHT levels >400ng/dL please post it here for everyone’s benefit. I haven’t found any.

 

[RobRoy]

I read the article when originally published years ago. If you find a long term study of men with DHT levels >400ng/dL please post it here for everyone’s benefit. I haven’t found any.

Studies of > 400? How about 700?
"In all of these studies, DHT treatment resulted in sustained increase serum DHT to high supra- physiologic levels of DHT [e.g., in the range of 700 ng/dL for up to 24 months "

Well first and foremost you have to understand the physiology and that DHT is a paracrine hormone and that the circulating levels have nothing to do with intra-tissue levels. But I do think raising it 10 times, 16 times, and 40 times normal will give you an idea if there's any harm. DHT has also been raised for decades in men on testosterone and yet no harm shown. DHT has been raised significantly with transdermal preparation's and once again no harm shown. So maybe you can show us we're raising DHT with testosterone or DHT itself has been shown to be harmful. Can you do that? In medicine when we say something might do something it means that it doesn't. In medicine when something has shown to do something we say that it does. It's like saying there might be men on Mars. There's not but I guess you could always say there might be…
There's also a saturation effect where DHT can only rise to a certain level and then it can rise no more. I think decades of raising DHT with testosterone has proven itself to be safe.
"Circulating levels of DHT in response to 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. Observations from numerous clinical studies are consistent with current knowledge that androgen-sensitive tissues can self-regulate tissue DHT levels by downregulating its synthesis and upregulating metabolism during DHT excess or, conversely, upre- gulating synthesis and downregulating metabolism under conditions of T or DHT deprivation. We are reminded of Horton’s admonition some  years ago when he concluded that blood levels of DHT provide only a hint of tissue levels and that DHT should be regarded as a paracrine hormone formed and acting primarily within target tissues".

 

[Charliebizz]

Well first and foremost you have to understand the physiology and that DHT is a paracrine hormone and that the circulating levels have nothing to do with intra-tissue levels. But I do think raising it 10 times, 16 times, and 40 times normal will give you an idea if there's any harm. DHT has also been raised for decades in men on testosterone and yet no harm shown. DHT has been raised significantly with transdermal preparation's and once again no harm shown. So maybe you can show us we're raising DHT with testosterone or DHT itself has been shown to be harmful. Can you do that? In medicine when we say something might do something it means that it doesn't. In medicine when something has shown to do something we say that it does. It's like saying there might be men on Mars. There's not but I guess you could always say there might be…
There's also a saturation effect where DHT can only rise to a certain level and then it can rise no more. I think decades of raising DHT with testosterone has proven itself to be safe.
Circulating levels of DHT in response to 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. Observations from numerous clinical studies are consistent with current knowledge that androgen-sensitive tissues can self-regulate tissue DHT levels by downregulating its synthesis and upregulating metabolism during DHT excess or, conversely, upre- gulating synthesis and downregulating metabolism under conditions of T or DHT deprivation. We are reminded of Horton’s admonition some  years ago when he concluded that blood levels of DHT provide only a hint of tissue levels and that DHT should be regarded as a paracrine hormone formed and acting primarily within target tissues ().

If serum levels aren’t reflecting what’s going on in the tissue, why are we then saying the positives from transdermals are from the sky high dht levels in the blood test ? And why do we tell everyone that transcrotal cream raises dht significantly more then injections ?

 

[tareload]

Its okay to be wrong

Welcome back @RobRoy. How you been?

I am curious, why do you post with an anonymous account and exchange Dr. Saya on these topics when your prior account is still fully functional from what I can tell? Do you not want your claims or posts here associated with your professional practice?

I mean I get it and I post on these topics anonymously but I don't make money providing clinical care for people. Seems like Dr. Saya is at a disadvantage publicly commenting here with another presumed Dr. who is anonymizing himself. Equivalent of a public debate where on one side you have live person whose identity is known and on the other side of the stage you have a TV screen with person's face concealed and their voice changed to conceal their identity.

My layman's comments and questions
It's an interesting topic for sure. What do you see in Fig. 2 that is drastically different than the serum profiles of TT/DHT with men on large daily dosages of T cream to the scrotum? What happened to the serum TT levels of the DHT subjects during the trial while the DHT was elevated to supra levels?

Also, would you care to comment on the U-shaped nature of the panels in Fig. 5? How would you reconcile Fig 2 vs Fig. 5 in terms of overall risk of supraphysiologic levels of circulating hormones long term (Fig 5) vs 24 months (Fig. 2)?

Any comments on Fig. 4:

FYI, the comments you marked on the pdf have a name associated with them in case you meant to not post that:

Thanks for sharing the paper. Another good one I was reading recently:

Dihydrotestosterone Administration Does Not Increase Intraprostatic Androgen Concentrations or Alter Prostate Androgen Action in Healthy Men: A Randomized-Controlled Trial

Exogenous dihydrotestosterone (DHT), which substantially raises serum DHT and lowers serum T, does not significantly alter intraprostatic androgen levels or androgen-responsive gene expression in healthy men.Concern exists that androgen treatment might ...

www.ncbi.nlm.nih.gov

 

[tareload]

Oh yeah I wanted to ask you @RobRoy is this profile consistent with the serum levels you are seeing with your patients?



Was curious.

Are you still typically Rx'ing 150 - 200 mg Test via cream twice daily on scrotum?

 

[tareload]

He measures 5 hours after application. 1600. Free 53. Feel better than ever and ever thing we can measure had improved. So when it is all said it’s what makes me healthier not what makes you happy or your opinion based on not treating 1 single patient

Sorry you answered this for me already. Yep, I am pretty close with my calculations. Thanks.

 

[Jerajera]

Is it possible high DHT could be detrimental to cardio health because of its antagonistic action on Estrogen receptors?

If you have so much DHT antagonizing Estrogen isn't it possible you would effectively suffer the consequences of low E2 levels even though technically your serum E2 levels wouldn't be affected?

 

[RobRoy]

If serum levels aren’t reflecting what’s going on in the tissue, why are we then saying the positives from transdermals are from the sky high dht levels in the blood test ? And why do we tell everyone that transcrotal cream raises dht significantly more then injections ?

because there is a saturation point in the tissues. So yes cream will raise DHT levels higher than injections but there is a saturation point. Once that saturation point occurs raising DHT any further has no effect. The prostate saturation point is at a really low testosterone level for instance (250 ng/dL).

 

[Tman]

Let's remain open to debate and willing to hear other viewpoints...that is how we've advanced to this point in TRT, in the first place. If we shut down or target alternative opinions, we'd all receive 1 shot every 2 weeks. It wasn't that long ago that everyone was advocating for an AI, either. Some clinics mix it into their creams...no option. Now the pendulum has swung the other way for many. Point...medicine is evolving and it will only evolve if we have doctors who are willing to continuously reflect, question, debate, and evaluate. Agree or disagree...I appreciate the discussion and alternative viewpoints. I will let my own research guide which way I go.

 

[Charliebizz]

because there is a saturation point in the tissues. So yes cream will raise DHT levels higher than injections but there is a saturation point. Once that saturation point occurs raising DHT any further has no effect. The prostate saturation point is at a really low testosterone level for instance (250 ng/dL).

Do we have any literature on that? I honestly haven’t read much about dht

 

[tareload]

Let's remain open to debate and willing to hear other viewpoints...that is how we've advanced to this point in TRT, in the first place. If we shut down or target alternative opinions, we'd all receive 1 shot every 2 weeks. It wasn't that long ago that everyone was advocating for an AI, either. Some clinics mix it into their creams...no option. Now the pendulum has swung the other way for many. Point...medicine is evolving and it will only evolve if we have doctors who are willing to continuously reflect, question, debate, and evaluate. Agree or disagree...I appreciate the discussion and alternative viewpoints. I will let my own research guide which way I go.

Just read the entire thread. Quite some viewpoints. Love claims about 1500 to 2000 ng/dl TT levels in the good ole days. Someone call the 1970s and ask where those dudes are. I can't find them.

Love to hear folks opinions or answers on my questions.

 

[tareload]

"The normal range of testosterone is reported as 350- 1200ng/dl. Studies in the 1940's showed the average testosterone level to be at 700 ng/dl, 300 ng/dl higher than for men today. In the past, a drop in testosterone levels to 250 ng/dl was rarely reported before men were 80 years of age. Yet today, it is not an uncommon value for middle aged men! "
I also have seen mention (assume this is estimated) that slim tradesmen as recent as a hundred years ago had levels up to the 2000 range. In my town, Italian stone workers built loose stone walls with little equipment in the 1870's, looking at pictures of these men, you realize how strong and wiry they were. What they weren't, was built like contemporary bodybuilders.

You got a link to those papers? Was just pulling one from 1890s the other day unrelated to this topic. So nice we have so much digitized. Much easier now than the good ole days. Maybe that is why my TT/fT is so low, I am not climbing the stairs at the health science library as much as I used to.

 

[tareload]

I think allot of what you are saying is based on a lack of understanding. Some men need 30+ today where 50 years ago the same
Man did not. It’s obvious that today we are bombarded with toxins , edc’s and etc.

I know plenty of men who tried 150 or 200mg or 2 Clicks scrotal and never felt better. They stayed feeling like Shit until dose was increased. Looking at lab ranges alone these men are screwed. This is wrong.

so much has changed with our environment and health today.


1. Ten years ago lab ranges were up to 150/1600 ng. This was based on the population. No lab company would allow lab ranges this high if it wasn’t shown in the general public.

2. last year it was 1200. This year 900. how can you sit there and not acknowledge this. It’s obvious lab ranges are based on a sick population and your post is saying that anyone that hits 1500 is using steroids. So tell me something. Are you going to tell
Men next year they shouldn’t go above 900?

3. When we do trt the goal is to find a dose that resolves symptoms as you stated. Yet in the other hand you say anything over 1599 is unsafe. You do realize that total is shit. One guy can convert 25 free t from 1k and another man needs 2k to get 25 free t. Next the free t ranges have also dropped over the years. Yet you state that nobody has had these levels. How about this. My father is 75 and his total is 600 and free t is 12. Imagine how high his levels were at 20? I’m sure they were 1500+ and free t was probably in the high 20s or above today’s lab ranges at the least. Your lab range fears are based on a sick population and ignorance of the health we used to have. Studies have been run that state we have much less hormones today than our ancestors. Can we at least acknowledge this and stop referencing sick folks levels?

Nobody is saying you need 3k to be healthy. What we are saying is don’t compare yourself to these horrid lab ranges based on a sick population. You are unique and you might need more T than the next guy. What you are doing is speaking in absolutes and condemning men based on your own fears.

3. With proper research we find that our receptors are not desensitized or saturated. Seriously get rid of your confirmation bias and research this topic with an open mind: forget everything you think you know and start there. You will find what i have found. There are some great studies out there. Go watch Scott howells video on YouTube about androgen receptors. He breaks down the studies and it’s obvious the fear is false.

4. if I need X Dose to feel normal. This is more than some and less than others. I see no reason to increase this dose much higher because I am simply doing trt. What I will not do is tell men they are going to die and suffer consequences if they have a higher dose than me. Some men simply need more. they tried a lower dose and slowly increased the dose until TRT worked for them. This is not abuse. This is therapy.

It is abuse when we find a dose that resolves symtoms and then proceed to increase this dose for further benefit of muscle gain, fat loss and whatever else.

Even then TRT doses do not cause the Health problems you reference. People who abuse anabolic use T as a base and add a dozen other produces on top are getting sick . This is why they are unhealthy. Including their diet and blocking their e2 levels. You are comparing apples to oranges.

You are not acknowledging that 200mg is too much for some men and not enough for others. It’s clear with lab results when a man takes 200mg and free t is 15 and he stays sick.
.



Your post is my reply to sh1973 as his comments were highlighted in red!


Now as to what you stated:

1. Ten years ago lab ranges were up to 150/1600 ng. This was based on the population. No lab company would allow lab ranges this high if it wasn’t shown in the general public.

- bull****.....show me the data and as I said levels at such in healthy young men would have been far and few and that would have been using inaccurate testing methods

- and you very well know the previous assays used were not accurate.....as I stated in a previous post.....which you seem to have a hard time comprehending Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe


2. last year it was 1200. This year 900. how can you sit there and not acknowledge this. It’s obvious lab ranges are based on a sick population and your post is saying that anyone that hits 1500 is using steroids. So tell me something. Are you going to tell
Men next year they shouldn’t go above 900?

- your wrong again.....top end of 1200 was up until 2017 and again reason the top end was dropped from 1200--->900 was due to more accurate testing methods (LC/MS-MS) based off data from populations of healthy young men

- you need to read over all my posts again as I never stated that a TT 1500 ng/dL is steroid levels.....that would be extremely high supra-physiological levels as in 2000-3000 + ng/dL range

- my reply to sh1973.....read that post over thoroughly before you state such!
View attachment 8526


- read over my reply to userjoe while your at it
View attachment 8527


3. With proper research we find that our receptors are not desensitized or saturated. Seriously get rid of your confirmation bias and research this topic with an open mind: forget everything you think you know and start there. You will find what i have found. There are some great studies out there. Go watch Scott howells video on YouTube about androgen receptors. He breaks down the studies and it’s obvious the fear is false.

- lol.....you another one of those caught up in this testosterone resistance thing.....if anything maybe in older men or men who have previously used/abused testosterone/AAS

- refer me to some of the research/studies regarding testosterone resistance

- the sensitivity of the AR and CAG repeat length (short/long) has been shown in studies to play a role in the genomic/non-genomic effects of testosterone.....much research is being done in this area and it could very well change the approach to how men with low-t/using trt are treated in the future

- dig up some of my older threads from 2-3 years ago


4. if I need X Dose to feel normal. This is more than some and less than others. I see no reason to increase this dose much higher because I am simply doing trt. What I will not do is tell men they are going to die and suffer consequences if they have a higher dose than me. Some men simply need more. they tried a lower dose and slowly increased the dose until TRT worked for them. This is not abuse. This is therapy.

- you should be addressing this to sh1973.....as you seem to be questioning me.....when a majority of your post relates to him as again I never stated such if you actually took the f***ing time to read my previous post (reply to sh1973 pg.6)

- think deeply before you come at me ranting and raving....."BIRD"
View attachment 8528


It is abuse when we find a dose that resolves symtoms and then proceed to increase this dose for further benefit of muscle gain, fat loss and whatever else.

- again never stated such as abuse would be running levels in the 2000-3000 ng/dL range which no healthy young male would ever produce naturally.....let alone use/need for trt

- when on trt most are using 100-150 mg/week......others are using 200 mg/week (considered the high end) and some may use slightly higher doses 250-300 mg/week (very rare one would need such a dose) and as you should very well know even with healthy testosterone levels as in top end of the physiological range or over say 1200-1500 ng/dL .....when following the proper diet/training protocol the muscle/strength gains will be minimal compared to one using very high doses of 300-600mg/week which would have ones testosterone levels in the extremely high supra-physiological range (steroid levels) 2000-3000+ ng/dL and even than muscle/strength gains would be greater using doses in the higher end 500-600 mg/week.

- there is no comparison regarding muscle/strength gains when using trt vs steroids.....it is like night and day.....so if your main goal is gaining any appreciable or significant muscle let alone significant strength gains than trt doses are pointless and you better be planning on using steroid doses to achieve extremely high supra-physiological testosterone levels.....end of story!


Even then TRT doses do not cause the Health problems you reference. People who abuse anabolic use T as a base and add a dozen other produces on top are getting sick . This is why they are unhealthy. Including their diet and blocking their e2 levels. You are comparing apples to oranges.

- again never stated such idiot!

- you need to be addressing sh1973

- everything highlighted in red below was stated by sh1973.....I responded!
-----------------------------------------------------------------------------------------------------
"I can assure you that anyone running numbers that high long term will pay a price".....1500-1600 ng/dl

- a little extreme here as it is highly doubtful even such levels would cause any significant negative health effects

- if anything aside from elevated hemoglobin/hematocrit/rbc's and possible lowering of hdl most of the side-effects at such level would be cosmetic such as oily skin/acne (genetically prone)/male pattern baldness (genetically prone)/increased body hair/gynecomastia (genetically prone)/water retention and bloating




"If you don’t care about your long term health then run 2000ng or higher"

- again even than running extremely high supra-physiological levels as in 2000-3000+ ng/dL long-term.....aside from what I stated above I will say that there may be an increased risk of negative effects on cardiovascular function (heart/blood vessels) but there is no data from long term studies (5-10 year) RCT's using very high dosages resulting in extremely high supra-physiological testosterone levels nor would there ever be as it would be considered unethical.

- at such levels long-term no one can say for sure if it is a given and as we should know ones genetics/lifestyle/underlying health issue will all contribute to whether one experiences such




"We didn’t need 15-1600ng going through puberty and certainly don’t as aging men"

- I will agree that no average healthy young male would ever naturally produce such

- 50th percentile (500's ng/dL).....75th (600's).....95th (800's).....97.5th(900's)

- are there outliers above 900's.....1000+.....sure far and few!


Trt is meant to be within physiologic limits not anabolic steroid levels.

- most mainstream doctors think such as they are dead set on keeping their patients TT within a certain range (mid-normal is common) and to them anything above is a cause for concern

- as we very well know a doctors main concern should be treating the patient symptoms not numbers while at the same time keeping ones overall health in mind.....so we are seeking out relief/improvement and increased overall well-being of the patient while at the same time minimizing/preventing any potential negative effects whether health related/cosmetic.....this is why blood work is CRITICAL!

- we also know that many men need to have their TT levels at the top end of the range or slightly higher in order to achieve a healthy FT level which would result in relief/improvement of low-t symptoms

- numbers/reference ranges should be used as guidelines as it is not set in stone that one needs to stay within these ranges.....but again it is highly doubtful one would need to venture into these absurd TT levels 1500-2000 ng/dL to achieve a healthy FT level.




"Not being argumentative but calling complete BS to guys stating they need these insanely high numbers to be normal, just isn’t factual"

- normal.....who wants to be normal.....as they say it's about being optimal/tuned-up/slightly jackd' bruh.....LOL!

- more is always better man.....I feel my best bruh!

- on a more serious note I agree that most would never need to be running these absurd TT levels 1500-2000 ng/dL.....let alone FT levels double the top end 50-60+ ng/dL..... as I find it ridiculous that the majority of men pre-trt have low <16 ng/dL or sub-optimal (high teens/low 20s) FT and all of a sudden go on trt and now supposedly need their FT levels almost triple 50-60 ng/dL compared to what they naturally produced when they had low-t.....hell would put money on it that most men in their PRIME were not even hitting low-mid TT 20 ng/dL at peak with average FT levels.




Of course symptom relief is what truly matters but we need to be sensible here as to what levels are truly needed.

Again to each his own and I have no issues if one chooses to run such levels.....but in most cases highly doubtful it is truly needed to experience the beneficial effects of trt.

-----------------------------------------------------------------------------------------------------




You are not acknowledging that 200mg is too much for some men and not enough for others. It’s clear with lab results when a man takes 200mg and free t is 15 and he stays sick.

- again I have stated many times in numerous previous threads that on average most meen need 100-150 mg/week to achieve a healthy FT level (top end or higher) and others may need a higher dose (200mg/week) to achieve such but it is not as common and yes there are some that run 250 mg/week (which is rare and would never be needed by most).

Survey from 1970s and 1980s literature on TT/RIA:

Hourly Intraday testosterone profiles in young eugonadal (healthy functional) men (1973-1983)

 

[bixt]

paracrine

Paracrine....a term used to duck and dive away from science. All the while making the observing layman think the writer is far more knowledgeable than he is. Used often by D Bossa and crew.

Bullshit asymmetry.

You want to know what happens when DHT is sky high for long? Theres millions of posts of what high doses of masteron, winstrol, actual DHT, methylated DHTs etc etc etc do when used for long.

 

[Charliebizz]

Paracrine....a term used to duck and dive away from science. All the while making the observing layman think the writer is far more knowledgeable than he is. Used often by D Bossa and crew.

Bullshit asymmetry.

You want to know what happens when DHT is sky high for long? Theres millions of posts of what high doses of masteron, winstrol, actual DHT, methylated DHTs etc etc etc do when used for long.

because there is a saturation point in the tissues. So yes cream will raise DHT levels higher than injections but there is a saturation point. Once that saturation point occurs raising DHT any further has no effect. The prostate saturation point is at a really low testosterone level for instance (250 ng/dL).

Just because we have an “alleged” saturation point. Does that mean it’s healthy long term to be “saturated” 24/7 365 ??

 

[tareload]

Evidently yes!

What is TRT and What is NOT TRT

You like charts and graphs and shit. You are like the guys in the world of finance that look at charts only, but do not look at the sentiment, economic and political situation. You are the type of guy who probably tells men they are abusing T because your chart says they need to use less. Yet...

forums.t-nation.com

...
You like charts and graphs and shit. You are like the guys in the world of finance that look at charts only, but do not look at the sentiment, economic and political situation.
You are the type of guy who probably tells men they are abusing T because your chart says they need to use less.
Yet you do not take into consideration every person is unique, their biology/makeup is genetically unique. everyone has a different lifestyle.
What about SHBG.
Its obvious in the world of TRT, most people need way more than 100. Your only refute is that you have a few charts that prove otherwise.
That chart doesnt tell you anything about the person or persons being tested and evaluated though.
That chart doesnt take into consdieration the heatlh of the person when they started. it doesnt take into consieration their shbg or other factors that could cause a need for more T.
A recent report a few years ago clarified that men have much less T in their body then our ancestors. Why? You know why. its not evolution. it’s unhealthy.
My body is an engine and most men aim to keep it optimal.
I am not wasting my time reading essays and articles by people who have never put their education to tthe test in the clinic world. These are the same people who look at lab results and tell their patient their levels are great, but they never ask the patient how they feel.
My doctor keith nichols is intelligent and his mentor Dr. Rouzier has trained hundreds of dcotors. They have both read and research medical literature / studies, and taken care of hundreds of patients over the years. I get my information from them, the men on this forum/community and my own experience.
T is simply not harmful. Thats why these abusers in the world of body buildling take 1000mg and add on top. the T is simply not going to kill you . your body can only produce so much e and dht. its not like you will have 5k DHT and 1k E levels because you took 1000mg of cypionate. it doesn’t work like that. Even if it did, you wouldnt have enough receptors to use that much hormone.
Their experience severely out-weights anything you bring to the table.
You are like a politician who has no clue what his voter base needs, because you never spoke with them with an open mind. You are like a fascist who knows what they need before you even discuss their needs with them.

 

[Hyrulewarrior1978]

This thread is kind of funny because everyone is arguing about the safety of long-term elevated dht, yet there aren’t any so-called long-term studies on the use of testosterone in general. And the fda explicitly states that trt shouldn’t be used for anti-aging purposes because of its unknown long-term effects, yet people are still doing it and doctors are still prescribing it lol. Whatever

 

[Jerajera]

I read the article when originally published years ago. If you find a long term study of men with DHT levels >400ng/dL please post it here for everyone’s benefit. I haven’t found any.

Hi Dr Saya, I thought you might find this additional data point interesting.

I ran labs on a protocol of 2 clicks (100mg) AM and 2 clicks PM of the 20% compounded Testosterone cream applied to the scrotum. I got my blood drawn at trough levels, 12 hours post application.

My TT and FT came back at the top of the range (1100ng/dL and 26ng/dL respectively), E2 (sensitive) at 55pg/mL and DHT at 500ng/dL (range 12-65ng/dL), around 8 times the top of the normal range.

This isn't completely surprising since even on Test C injections of 18mg/day (126mg/week), my DHT is 2x the range around 125ng/dL, with TT and FT only at the top of the normal range.

While there doesn't seem to be any long term studies on DHT levels that high, I'm going to exercise common sense here and assume that being at 8 times the range of any health marker or hormone is probably not healthily sustainable long term.

I did feel some mental/emotional benefits to the scrotal cream that I think I can reasonably attribute to the very high DHT levels since my TT/FT/E2 are around the same levels they were on injections, so I'm going to try a mix of injection and low dose cream to see if I can retain some of those advantages without shooting my DHT into the stratosphere

 

[Lumalux]

Hi Dr Saya, I thought you might find this additional data point interesting.

I ran labs on a protocol of 2 clicks (100mg) AM and 2 clicks PM of the 20% compounded Testosterone cream applied to the scrotum. I got my blood drawn at trough levels, 12 hours post application.

My TT and FT came back at the top of the range (1100ng/dL and 26ng/dL respectively), E2 (sensitive) at 55pg/mL and DHT at 500ng/dL (range 12-65ng/dL), around 8 times the top of the normal range.

This isn't completely surprising since even on Test C injections of 18mg/day (126mg/week), my DHT is 2x the range around 125ng/dL, with TT and FT only at the top of the normal range.

While there doesn't seem to be any long term studies on DHT levels that high, I'm going to exercise common sense here and assume that being at 8 times the range of any health marker or hormone is probably not healthily sustainable long term.

I did feel some mental/emotional benefits to the scrotal cream that I think I can reasonably attribute to the very high DHT levels since my TT/FT/E2 are around the same levels they were on injections, so I'm going to try a mix of injection and low dose cream to see if I can retain some of those advantages without shooting my DHT into the stratosphere

This is very interesting and confirms what we have already observed about scrotal application. Can you describe the benefits/effects you seem to be experiencing from the high DHT? As you know, I am interested in beginning this same protocol for various reasons.

 

[tareload]

yet there aren’t any so-called long-term studies on the use of testosterone in general. And the fda explicitly states that trt shouldn’t be used for anti-aging purposes because of its unknown long-term effects, yet people are still doing it and doctors are still prescribing it lol. Whatever

Maybe we should start a thread on that . TT/fT dose response and long term safety etc. That would be fun.