Primary hypogonadism induced by steroids

[DesperatedGuy]

Hi guys, i am new here. I am a young man in his 20's and i have primary hypogonadism induced by a long steroids cycle without the use of HCG.

In fact, 5 years ago, i did a Blast and Cruise for 1 year straight. I only used testosterone cypionate at 700mg/week during blast and 200mg/week during cruise, and nothing else. I did not use any HCG during 1 year, which gave me testicular atrophy but i did not care because everyone told me the balls will come back during PCT. But they didn't.

My LH and FSH returned normal very fast when i stopped taking testosterone but my testicles didn't responded. I am now stuck with a very low testosterone level in despite of high LH and FSH.


This is my bloodwork before the B&C:

Testosterone : 650ng/dl
LH: 3.5 mUI/L
FSH: 3.6 mUI/L

This is my last bloodwork 4 years after stopping the cycle :

Testosterone: 200ng/dl
LH: around 10mUI/L
FSH: around 10mUI/L

I did a lot of bloodwork after coming off testostrrone and it's always the same thing, similar to the one above : very low testosterone with high LH and FSH.

I read a few guys having a similar case than mine. They did not used HCG for a long time and it caused leydig cells death or desensitization. I think it's what happened to me. I almost do not respond to clomid or high HCG doses either. Clomid for a few weeks increased my testosterone around 300ng/dl with very high LH.

I think my leydig cells are partially dead.
My balls was normal in size before, i would say around 25ml each. Now the volume is only 10ml each. Very embarrassing. Extremely smalls. Also, my semen is almost completely watery. I am now infertile with a sperm count of around 10 millions per ml.

Any ideas? Thank you

 

[DesperatedGuy]

I have some ideas that i would like to share with you.

Last year i tried proviron only because i read it was used for fertility (i am not on TRT, clomid or anything). Very fast, my semen changed. It was very white and thick, not watery and transparent like usual. Maybe this means my sertoli cells can still work properly when there is enough intratesticular androgen activity? I stopped proviron because it gave me low estrogen symtoms (joints pain)

My leydig cells do not work anymore, so they dont produce enough intra testicular testosterone to properly stimulate the sertoli cells/ germ cells. Thats why i want to try testosterone cream on scrotum. It will increase intra testicular testosterone for sure. Maybe it will help with the size and fertility. A guy on a forum said he noticed his balls grew back when he switched from test cyp to the scrotal cream (he didn't use HCG).

What do you think guys?

 

[bixt]

The bog standard answer you are likely to receive on this forum is that your balls are permanently fried and TRT needs to be started.

However, look into Dr Scally "Power PCT". It involves some really massive doses of HCG, clomid and nolvadex to wake up hard shut down nuts. He has data to back it up.

Thats why i want to try testosterone cream on scrotum. It will increase intra testicular testosterone for sure. Maybe it will help with the size and fertility. A guy on a forum said he noticed his balls grew back when he switched from test cyp to the scrotal cream (he didn't use HCG)

Im very interested to hear about this. Generally, one would think that DHT (proviron) would just "keep you shut down". But plenty of people report semen thickening and an increase
n sperm count.

Im not too sure about scrotal scream increasing ITT, if you have any links please kindly share them.

Scrotal cream is proven to increase DHT, and perhaps that improves the semen in the same way proviron does?

 

[DesperatedGuy]

The bog standard answer you are likely to receive on this forum is that your balls are permanently fried and TRT needs to be started.

However, look into Dr Scally "Power PCT". It involves some really massive doses of HCG, clomid and nolvadex to wake up hard shut down nuts. He has data to back it up.




Im very interested to hear about this. Generally, one would think that DHT (proviron) would just "keep you shut down". But plenty of people report semen thickening and an increase
n sperm count.

Im not too sure about scrotal scream increasing ITT, if you have any links please kindly share them.

Scrotal cream is proven to increase DHT, and perhaps that improves the semen in the same way proviron does?

I will look into the power PCT thanks, but since i already have high LH i fear it will not work. But maybe the leydig cells need a crazy high stimulation to awaken them? Who knows. It's worth a try

Proviron doesn't shutdown everyone. I am 100% sure it increased my sperm count because i have very watery semen and with proviron it was very white and thick.

I dont have any links regarding scrotal cream and intratesticular testosterone level but it just sounds very logical to me.

 

[DesperatedGuy]

@madman
@Cataceous

Hi guys i know you have lot of knowledge. What do you think about my situation?

 

[Cataceous]

It's small consolation that the testicular effects of steroid abuse are now better quantified:

Serum Insulin-like Factor 3 Levels Are Reduced in Former Androgen Users, Suggesting Impaired Leydig Cell Capacity

AbstractContext. Illicit use of anabolic androgenic steroids (AAS) is frequently observed in men and is associated with subsequent testosterone deficiency

academic.oup.com

I'm not optimistic about what might be expected from a localized androgen therapy, but little harm in trying. I believe @madman has posted some information about stem cell therapy and Leydig cells, but this kind of treatment is probably many years off.

In the meantime I would go on TRT, tuning the dose so that LH and FSH are midrange. At least one other guy with primary hypogonadism has described having success with this approach. The advantage you have over guys with secondary hypogonadism is that with the tuning your HPTA remains largely functional; you won't suffer from the disruption of multiple other hormones.

 

[DesperatedGuy]

It's small consolation that the testicular effects of steroid abuse are now better quantified:

Serum Insulin-like Factor 3 Levels Are Reduced in Former Androgen Users, Suggesting Impaired Leydig Cell Capacity

AbstractContext. Illicit use of anabolic androgenic steroids (AAS) is frequently observed in men and is associated with subsequent testosterone deficiency

academic.oup.com

I'm not optimistic about what might be expected from a localized androgen therapy, but little harm in trying. I believe @madman has posted some information about stem cell therapy and Leydig cells, but this kind of treatment is probably many years off.

In the meantime I would go on TRT, tuning the dose so that LH and FSH are midrange. At least one other guy with primary hypogonadism has described having success with this approach. The advantage you have over guys with secondary hypogonadism is that with the tuning your HPTA remains largely functional; you won't suffer from the disruption of multiple other hormones.

Thanks for your response!

So youre saying TRT will not completely suppress my LH and FSH level because i am primary? I didn't know it was possible. great news

I want to try TRT but i dont want injections, i want to try scrotal scream for the DHT benefits and intra testicular testosterone (in theory). I heard scrotal cream was more suppressive than any other methods because we are putting the testosterone directly on the testicles so it's more suppressive this way. Do you know if it's true? Thanks

 

[bixt]

i want to try scrotal scream for the intra testicular testosterone (in theory)

False, unless proven otherwise. The testosterone absorbs via the thin skin and enters systemic circulation.

I heard scrotal cream was more suppressive than any other methods

You do realise you are contradicting your other reason (supposed increase in ITT, which would indicate less suppression) by stating creams are more suppressive?

But again, false. Creams can be potentially LESS suppressive, especially if applied once daily, and early morning.

we are putting the testosterone directly on the testicles so it's more suppressive this way

Again, incorrect. "Suppression" happens in the pituitary\hypothalamus. There is no negative feedback loop for testosterone production within the testicles.

 

[Cataceous]

...
So youre saying TRT will not completely suppress my LH and FSH level because i am primary? ...

Yes, as long as the dose isn't too high. Your serum testosterone should end up near where it would be naturally if the testicles were ok. You will need to be patient with the process—start low with the dose and increase slowly, monitoring LH.

...
I want to try TRT but i dont want injections, i want to try scrotal scream for the DHT benefits and intra testicular testosterone (in theory). I heard scrotal cream was more suppressive than any other methods because we are putting the testosterone directly on the testicles so it's more suppressive this way. Do you know if it's true? Thanks

I doubt scrotal cream is more suppressive than other forms of TRT. The degree of suppression should mainly be a function of the levels of circulating estrogens and androgens. Excess DHT caused by scrotal application cuts both ways: Being a strong androgen means it's possible that DHT is more suppressive than testosterone at the hypothalamus. However, DHT is also a potent anti-estrogen, which can reduce negative feedback from estradiol at both the hypothalamus and pituitary. The situation is further complicated by the interaction with the SHBG carrier protein. Higher DHT can increase the amount of free estradiol and free testosterone.

I have reservations about topical TRT in general because DHT frequently ends up higher than is physiological. Maybe it's ok, but it's still possible it will lead to other problems.

 

[DesperatedGuy]

False, unless proven otherwise. The testosterone absorbs via the thin skin and enters systemic circulation.


You do realise you are contradicting your other reason (supposed increase in ITT, which would indicate less suppression) by stating creams are more suppressive?

But again, false. Creams can be potentially LESS suppressive, especially if applied once daily, and early morning.



Again, incorrect. "Suppression" happens in the pituitary\hypothalamus. There is no negative feedback loop for testosterone production within the testicles.

"False, unless proven otherwise. The testosterone absorbs via the thin skin and enters systemic circulation."

Honestly maybe i am wrong but it feels logical to me. DHT gel is used for gynecomastia and it worked for me. Same thing for transdermal tamoxifen used in breast cancer, it works applied on the breast while reducing systemic levels and sides. it can definitely act locally for a certain period of time. This is the same thing for NSAID. For exemple, Diclofenac gel is used to treat joint inflammation while reducing systemic exposure and sides compared with oral diclofenac

I am not contradicting. I am talking about suppression of LH and FSH levels. Spermatogenesis can happens without LH and FSH with artificial testosterone presence. I read a study where they suppressed FSH and LH in rats but injected testosterone directly in the testis and it induced spermatogenesis (i tried to find the study but i dont remember where i read it). So in theory you can have ITT/spermatogenesis while being totally shutdown (no LH and FSH) if you use this method. But of course FSH is important for optimal spermatogenesis too.

Suppression doesn't only happens in the pituitary. It also can happens via Leydig cells feedback when they detect presence of androgens.

 

[DesperatedGuy]

@Cataceous

I am also very interested in trying the Natesto method

I cant use it in my country, but i can easily do a similar thing with testosterone base powder mixed in pure DMSO and applying the solution on my skin. Pure DMSO will provide at least 80 % systemic testosterone absorption.

Lets say 5-10mg x 3 per day. I think it could work well while keeping the hpta active. And why not add a little DHT powder to the solution too (like 1-2mg per application) to counteract e2, i am very sensitive to it)

I tried testosterone in pure dmso applied on wrists a few months ago at 15mg 1x per day. Spectacular effects to be honest (regarding erection quality, sex drive and energy). I started to feel the effects after less than 1h but they only last for a few hours after each application and i had gyno symptoms (nipples itch and pain). So i stopped after 3 days.

Just for the information, testosterone base is soluble at least to 100mg/ml in pure DMSO. With my 1ml dropper, 1 drop = around 4mg. I find this method so easy for TRT

 

[bixt]

Wow....just wow. PHD level bro science

 

[Cataceous]

With Natesto they're relying on contact with the nasal mucous membrane to attain fast absorption. I wonder if DMSO can take testosterone through the skin faster than conventional transdermal products? I wouldn't add DHT unless you find it to be low later on.

If you're really getting 80% absorption then 15 mg of testosterone is too much. I'd start with half that or less.

 

[DesperatedGuy]

With Natesto they're relying on contact with the nasal mucous membrane to attain fast absorption. I wonder if DMSO can take testosterone through the skin faster than conventional transdermal products? I wouldn't add DHT unless you find it to be low later on.

If you're really getting 80% absorption then 15 mg of testosterone is too much. I'd start with half that or less.

Yes it's faster than conventional transdermal. But still not as fast as Natesto, which could compromise the hpta normal fonction

I found this study:

METABOLISM OF DMSO

Regardless of the route of administration of DMSO, a remarkable amount of radioactive DMSO is found in the plasma after only 30 minutes. Cutaneous administration of DMSO generally results in lower serum levels
than when DMSO is administered per os or intravenously.7 Maximal blood concentrations of DMSO applied cutaneously are reached in 2 hours.

An oral dose of 1g/kg-body weight results in peak plasma concentrations in 4 - 6 hours, and detectable levels persisted for 400 hours. DMSO administered intravenously at the same dosage achieves higher plasma levels and is rapidly distributed throughout all tissues.

DMSO is metabolized in animals and man to form dimethyl sulfide (DMS) and dimethyl sulfone (DMS02 ). DMSO and DMS02 arepresent in all examined tissues including both hard (i. e. lens and bone) and soft tissues. 3 Unaltered DMSO is by far the most prevalent in tissues, blood, feces' and urine, with DMS02 also present but in much smaller concentrations. A small percentage of the original dose of DMSO is reduced to DMS and exhaled.
It appears that the primary route of excretion of DMSO is through the urine. 8 One and one-half to two hours after cutaneous administration of DMSO, the highest concentration is found in the kidneys, indicating that
the kidney is the organ of excretion. In dogs, studies indicate that approximately 50% of a total dose of DMSO-35S is collected in urine after 36 hours whether given by oral or intravenous administration. 8 When DMSO-35S is applied cutaneously, only 12 - 25 % of the total dose is found in the urine collected over a
24 hour period. Only a small fraction of an original dose of DMSO is excreted in the feces, regardless of the route of administration. The biliary system also appears to play a role in the excretion of DMSO. In rats administered DMSO intravenously, 8% of the total dose is recovered in a 24 hour period. This suggests that a large portion of the DMSO dose is reabsorbed in the enterohepatic circulation.

The odoriferous breath associated with administration of DMSO led researchers to investigate the possibility of pulmonary excretion. It was found that a small amount of DMSO is reduced to DMS and exhaled in the breath. Approximately 3-6% of a total DMSO dose is exhaled in the breath, regardless of the route of administration.

 

[Systemlord]

So youre saying TRT will not completely suppress my LH and FSH level because i am primary?

This is pretty much the case for most, unless you've been on TRT for 40-50 years, then you will most likely be 100% shut down by then.

 

[Cataceous]

Yes it's faster than conventional transdermal. But still not as fast as Natesto, which could compromise the hpta normal fonction
...

This is still much less of an issue with primary hypogonadism. In secondary hypogonadism the upstream regulation of testosterone production is damaged, resulting in an unnaturally low set point for serum testosterone, e.g. 200 ng/dL. Any attempt to exceed this low set point with exogenous testosterone results in a reduction of endogenous production via HPTA suppression. Consider a thermostat analogy, in which house temperature represents serum testosterone, and the furnace represents the testicles. Secondary hypogonadism is like having your thermostat stuck on 50° F in the winter. The furnace is fine, but it's not being asked to make enough heat. If you then bring in an external space heater to force the temperature above 50° (use exogenous testosterone) then the stuck thermostat is rendered inactive and the furnace is not used (HPTA shutdown).

In your primary gonadism, however, the regulatory set point for serum testosterone is still ok. For example your natural set point might be 600 ng/dL. The problem is that the testicles can't make that much, so you have this situation where excessive LH reflects the unsatisfied demand for more testosterone. As you add exogenous testosterone, nothing much happens upstream until you near the natural set point. This is great, because it means you can push your serum testosterone up to a normal level, and only when going higher will negative feedback begin to suppress the HPTA. In the heating analogy, primary hypogonadism is like having a poorly operating furnace that can only heat your house to 50°, even though the thermostat is demanding more heat to try to reach the setting of 70°. In this case an external heater can bring the temperature up to normal—70° before the thermostat kicks off (HPTA shutdown).

Natesto is special because its short half-life means it can be used with secondary hypogonadism without too much HPTA suppression. The heating analogy become more of a stretch, but it's sort of like pulsing the external heat where it's needed, and far enough from the defective thermostat that it doesn't detect the heat and turn off. So your furnace provides the heat to maintain 50°, while the pulsed external heater keeps you comfortable.

 

[tareload]

https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1967.tb34906.x

 

[tareload]

Testosterone no ester in DMSO experiment

Hi guys. I am experimenting right know with an unconventional method for TRT. I made a solution of testosterone base in dmso and ethanol. I am applying it on wrist. My goal is to reproduce the effects of Natesto. The solution is 40mg/ml of testosterone in 80%dmso and 20% ethanol. I started...

www.excelmale.com

 

[tareload]

https://onlinelibrary.wiley.com/doi/10.1111/jvp.12476

Sorry @BigTex I had cut off the figure caption for Fig. 4

 

[tareload]

Natesto PK profile in humans.