Prescribed TRT scrotal cream at 23

[vic909]

Hello,

I'm 23 and used finasteride and other 5AR inhibitors when I was 18 which is about the time all my symptoms began. I have brain fog, poor memory, anhedonia, low libido, zero morning/nocturnal erections in many years, etc. I stopped the finasteride when I was 19 but the symptoms remained and my life was destroyed.

My testosterone is usually in the 500s and occasionally low 600s. Free testosterone has recently been 20.1 ng/dl (5.25-20.7). Estradiol was 29, SHBG 26, LH 4.2, IGF-1 181. DHT was tested about a year ago and was 260 (112-955). The only hormones that are consistently elevated are adrenal ones. DHEAS is usually in the 700s (80-560), Progesterone was recently 2.4 (0.2-0.9), and pregnenolone was 1100 (55-450).

I have seen multiple endocrinologists who told my I do not have congenital adrenal hyperplasia, only one said I might have a mild form and tried small doses of prednisone to suppress the elevated adrenal hormones but it didn't help with symptoms.

I recently had a consult with a Dr. from Defy and was told I could try testosterone cream applied to the scrotum in order to see if the rise in DHT would improve my symptoms. I was told to do 2 clicks AM and 2 clicks PM but was also told I could start with just 2 clicks AM at first if I like. I was also prescribed 350 IU of hCG 3x a week.

I never wanted to use TRT at this age and shut down my own production especially since my testosterone levels are pretty decent but I don't know what else to do.

I would sincerely appreciate any advice you can give me.

Thank you

 

[DaveK22]

It's very likely you have PFS. I suggest you also join the propciahelp forum where you may find lots of useful information.
propeciahelp forum

 

[vic909]

It's very likely you have PFS. I suggest you also join the propciahelp forum where you may find lots of useful information.
propeciahelp forum

I've been there but unfortunately there aren't really any treatments at the moment.

 

[DaveK22]

I've been there but unfortunately there aren't really any treatments at the moment.

Correct but at least you're familiar with it I see. Not even Dr Crisler or Shippen had any answers for that poison.

 

[sammmy]

Although it doesn't seem likely to help, you can try the scrotal T cream and if it doesn't work in a few months just stop it. Your natural T levels should restore to baseline in 1-2 months later.

 

[vic909]

Although it doesn't seem likely to help, you can try the scrotal T cream and if it doesn't work in a few months just stop it. Your natural T levels should restore to baseline in 1-2 months later.

Would I just stop it cold turkey or would I need something like clomid? Also, will I feel even worse during those 1-2 months until my natural production comes back? Thank you.

 

[sammmy]

Cold turkey. The "post cycle therapy" is pointless - your body will sense there is not sufficient testosterone, there is no need to "remind it" by blocking receptors with clomid.

I've done transdermal testosterone and frankly don't even remember feeling worse after stopping it cold turkey. The "feeling worse" period is exaggerated in bro-science folklore.

 

[sammmy]

Also you may want to expand your hypothesis instead of focusing solely on PFS as the only explanation of your symptoms.

If your adrenal hormones are elevated, have you done CT or MRI scans of the adrenals and cortisol test?

Brain fog, poor memory could be a problem with the brain. If your memory is really bad, you could go to a neurologist to get brain MRI.

 

[sammmy]

ACTH test is another thing to do, since the problem may be in the pituitary - it signals the adrenals to produce hormones. Endocrinologists must have checked for that.

 

[vic909]

ACTH test is another thing to do, since the problem may be in the pituitary - it signals the adrenals to produce hormones. Endocrinologists must have checked for that.

I’ve seen 4 separate endocrinologists and done many tests. Adrenal CT came back normal. ACTH stimulation test came back with elevated Pregnenolone but not 17-OH progesterone which if elevated would have meant congenital adrenal hyperplasia. My cortisol is always slightly elevated, usually around 25 or 26, doctor said that’s fine.

I also have thought it could be something other than PFS and maybe it is but I’ve seen multiple doctors and none are able to provide me with answers. I personally do think the issue is receptor related due to the fact that I experienced a temporary recovery for about a week back in 2019. I was completely cured for an entire week 2 days after having an ACTH stimulation test. Then one day I woke up with extreme libido and before suddenly crashing from one second to the next. I tried having a second acth stimulation test done but I did not have the recovery again.

I’m completely lost and have been suffering from these symptoms since I was 18. Whether it’s PFS or not it seems like I do not respond to androgens in the way I used to. I even tried 50mg of proviron for 2 weeks without any effects.

 

[FangFang]

Frankly this forum needs a PFS section. You're describing the symptoms perfectly. I'll endeavor to be more helpful when I get time to type.

 

[Fortunate]

I would tend to tread lightly. Seems like you might be using a hammer to turn a screw. In other words, the wrong tool to address a problem.

Any chance that some of his brain fog could be post Covid syndrome? Unresolved depression?

 

[vic909]

I would tend to tread lightly. Seems like you might be using a hammer to turn a screw. In other words, the wrong tool to address a problem.

Any chance that some of his brain fog could be post Covid syndrome? Unresolved depression?

Symptoms were there long before Covid. Psychologist agreed it’s not depression due to the nature of the symptoms and how they appeared.

 

[eli]

What! Your levels are great, except the DHT. Don't touch testosterone yet. Don't listen to Defy, of course they'd love you to jump on their protocol $$$
You should try creatine, it increases DHT.
Try boron as well

 

[vic909]

What! Your levels are great, except the DHT. Don't touch testosterone yet. Don't listen to Defy, of course they'd love you to jump on their protocol $$$
You should try creatine, it increases DHT.
Try boron as well

I’ve tried creatine and boron without any improvement. Would it hurt to try the testosterone for a month or two just to see if higher DHT improves my symptoms?

 

[Systemlord]

Don't listen to Defy, of course they'd love you to jump on their protocol $$$

It’s as if your implying Defy Medical is crooked because they charge for treatment. Last time I checked, my healthcare provider bills my insurance company for treatment and services.

Places like Defy Medical are very necessary in a world where TRT in under recognized in western medicine after repeat studies showing how safe and effective it can be.

There are a large number of men that would greatly benefit from treatment but instead are bring shown the door out of ignorance.

I do agree with you on one thing, @vic909 is trying to force his body to heal faster by way of androgen onslaught that may prolong or prevent recovery from PFS.

Maybe I‘m wrong.

@vic909 has above average testosterone.

 

[vic909]

It’s as if your implying Defy Medical is crooked because they charge for treatment. Last time I checked, my healthcare provider bills my insurance company for treatment and services.

Places like Defy Medical are very necessary in a world where TRT in under recognized in western medicine after repeat studies showing how safe and effective it can be.

There are a large number of men that would greatly benefit from treatment but instead are bring shown the door out of ignorance.

I do agree with you on one thing, @vic909 is trying to force his body to heal faster by way of androgen onslaught that may prolong or prevent recovery from PFS.

Maybe I‘m wrong.

@vic909 has above average testosterone.

I'm not trying to force my body to heal faster, I'm questioning whether it can heal at all without intervention. It's been almost 6 years of me living like this. It's like a switch suddenly turned off in my head and the old me died.

I know my testosterone is normal, however since my DHT is towards the lower end and since DHT has a much higher binding affinity to androgen receptors than TRT, I was thinking of trying the scrotal cream because it converts to DHT at a much higher rate.

Yes it's likely the TRT cream won't work but at this point I'm willing to try anything and don't know what else I can do.

Propeciahelp is starting studies soon, but by the time the exact mechanism of PFS is revealed or if even possible a treatment is discovered, I would probably be in my 30s.

 

[eli]

I'm not trying to force my body to heal faster, I'm questioning whether it can heal at all without intervention. It's been almost 6 years of me living like this. It's like a switch suddenly turned off in my head and the old me died.

I know my testosterone is normal, however since my DHT is towards the lower end and since DHT has a much higher binding affinity to androgen receptors than TRT, I was thinking of trying the scrotal cream because it converts to DHT at a much higher rate.

Yes it's likely the TRT cream won't work but at this point I'm willing to try anything and don't know what else I can do.

Propeciahelp is starting studies soon, but by the time the exact mechanism of PFS is revealed or if even possible a treatment is discovered, I would probably be in my 30s.

Your Free Testosterone is at the top of the range, something men wish they could have naturally around here. Total testosterone doesn't mean much.

Did Defy ask you for further testing? Vitamin D? Thyroids? Did you do a full panel? Prolactin? Progestogen?

 

[eli]

It’s as if your implying Defy Medical is crooked because they charge for treatment. Last time I checked, my healthcare provider bills my insurance company for treatment and services.

Places like Defy Medical are very necessary in a world where TRT in under recognized in western medicine after repeat studies showing how safe and effective it can be.

There are a large number of men that would greatly benefit from treatment but instead are bring shown the door out of ignorance.

I do agree with you on one thing, @vic909 is trying to force his body to heal faster by way of androgen onslaught that may prolong or prevent recovery from PFS.

Maybe I‘m wrong.

@vic909 has above average testosterone.

I didn't say crook but to put this guy on TRT without furthering testing is BS. He needs more blood work.

 

[Systemlord]

I know my testosterone is normal, however since my DHT is towards the lower end

I know Dr. Rob Kominiarek has a protocol for getting guys off DHT blocking medications even if their not on TRT. The protocol jacks the DHT very high so the DHT receptors don’t atrophy as the medicine is withdrawn.

He also says if not having any problems, don’t ever come off, because for some that’s when the SHTF.