Seagal
Well-Known Member
When is the peak? 1-2h after cream application? And maybe two peaks per day?
Supra physiological FT
- Thread starter Seagal
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Yes nothing wrong with cardio and boosting one's VO2 max.
For me personally, I Powerlift and every body has a threshold limit for physical output. (Maximal Recoverable Volume) I cannot Lift hard/Hvy and also workout long. Therefore, I also cannot afford the energy and recovery expenditure of any high level of cardio. Neither could Dave Lee on there, while Powerlifting. But, for something like Muay Thai, extra cardio is absolutely vital to the objective. However, I admit, I could have a little better cardio level and I would benefit from it.
Good point: No # to determine Low T. So, if there is no # to define Low T, I gotta ask; how is there a specific # to define High T or Supraphysiologic level?? (there isn't)
"why do we hang our hat on a #"?
1970's: "patient centric". Today: "Lab centric"
Side effects VS side benefits. YES!!! That's a great way to phrase it. Maybe I get a few "Side effects" BUT! If my side benefits out weigh the side effects, how can my therapy truly be faulted? If it could be accurately quantified, and the patient was told; You can go back to the same shitty life you had before TRT Or on your current Therapy, you will obviously feel much better. But, you "may" cut 10yrs off your life span, how many guys who actually had uncountable Low T symptoms and a piss poor life before, would say; "Sign me up for the Good stuff! Sign me up for Symptom mitigation and a chance to live my Best life right freaking Now! I know I would, hands down. -I may die 10yrs sooner for a thousand different reasons having NOTHING to do with TRT anyway...
A lot of great info. But very long. So, I'll finish it later.
Thx for the post
FunkOdyssey
Seeker of Wisdom
Closer to 4 hours I think. And he does usually prescribe twice daily administration so yes, there would be two peaks.
madman
Super Moderator
Still babbling on about those reference ranges/guidelines LOL!
Starting to sound like all those other sheep!
Natty vs hypogonadal men on T therapy
Natty
Healthy functioning HPG-axis.
Every man has. a natty genetic set-point within the physiologic reference range other than those outliers as in men with high SHBG that would be hitting those 1000+ ng/dL T levels and even then depending on where their TT/SHBG sits its not a given that they are running around with a high peak FT.
Those natty men hitting that high peak FT would be those outliers.
Natural endogenous testosterone secretion is both pulsatile and diurnal.
Average daily production is 5-7 mg.
During the normal 24-hour circadian rhythm of a healthy young male T levels gradually rise overnight reach a peak in the early morning then decline throughout the day with lower levels in the late afternoon and a trough (lowest point) in the evening.
Fluctuations from peak--->trough are typically 20-25%
The daily morning peak is transient as in short-lived.
The men hitting those FT levels that fall in the upper limit of the reference range as in 25.3 ng/dL would be those outliers as in few and far between.
Those high values represent a transient morning peak not a level maintained throughout the day and sure as hell not a trough value.
There is a natural ebb and flow as the body was never meant to be AMPED up on T 24/7.
Hypogonadal on T therapy
Underlying HPG-axis dysfunction as in primary (testicular failure) or secondary (hypothalamic/pituitary dysfunction).
Treatment with exogenous T will result in a strong suppression of the HPG-axis.
LH stimulates the Leydig cells in the testes to produce ITT (intratesticular testosterone) and ITT/FSH stimulates the Sertoli/germ cells located inside the seminiferous tubule lobes to produce sperm.
When one uses exogenous testosterone/AAS it results in shut down of the HPG axis and the pituitary no longer secretes LH/FSH.
Lack of LH causes atrophy of the Leydig cells which are located between the seminiferous tubules and lack of ITT/FSH causes atrophy of the Sertoli/germ cells which are located inside the seminiferous tubules. The cells shrink and become dormant.
The body no longer produces endogenous testosterone and sperm production is halted.
The Leydig cells only make up 10-20% of testicular volume as oppose to the germ cells/seminiferous tubules (where sperm is produced) which make up almost 80% of the testicular volume so a majority of the shrinkage results from atrophy of the germ cells/seminiferous tubules.
Basically comes down to exogenous testosterone use results in significant suppression of spermatogenesis which leads to testicular shrinkage as a majority of teste volume is made up of germ cells located in the tightly bundled seminiferous tubule lobes where sperm is produced.
Not only does FSH stimulate sperm production but ITT alone is also playing a strong role.
Regarding the use of hCG we can take it along with trt to maintain fertility/prevent testicular shrinkage.
The use of hCG will mimic LH and result in stimulating the Leydig cells in the testes to produce ITT which will have a big impact on stimulating the Sertoli/germ cells located inside the seminiferous tubule lobes to produce sperm and this will cause an increase in testicular volume.
Even with exogenous T + hCG the hypothalamus and pituitary remain highly suppressed.
hCG bypasses the suppressed pituitary by mimicking LH at the testes but it does not restore normal GnRH, LH, or FSH secretion.
Top it off that T solo without the use of hCG may have a negative impact on our long-term overall health due to the negative impact on upstream hormones.
The role of gonadotropins in testicular and adrenal androgen biosynthesis pathways -insights from males with congenital hypogonadotropic hypogonadism on hCG/rFSH and on testosterone replacement (link thread end of post))
* A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long term consequences for health and wellbeing. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.
When using exogenous T the natural 24hr circadian rhythm is thrown out the window as no T modality other than the Androderm T-patch (evening application) would most closely mimic such.
Even daily TP would never mimic such.
Numerous formulations to choose from here whether (nasal, buccal, oral TU, transdermal (cream/gel), pellets, injectable esterified T).
The majority of men are using injectable esterified T and the most commonly used esters (TC/TE) which are basically interchangeable.
Again the majority of men on T can easily hit a healthy/high trough FT injecting 100-150 mg T especially when split into more frequent injections.
Some men can achieve stellar levels injecting 100 mg T/week especially when split into more frequent injections.
Always going to be those outliers that will who may need the higher-end dose 200 mg T/week but those men would be few and far between.
Depending on the protocol (dose/injection frequency) there can be an extreme difference between the peak--->trough.
Once weekly would result in a big swing between peak--->rough and blood levels will not be as stable throughout the week.
Increasing the injection frequency as in 3x weekly (M/W/F), 2x weekly (every 3.5 days), EOD or daily will clip the peak and bring up the trough and blood levels will be more stable throughout the week.
Injecting daily would result in a minimal peak--->trough and blood levels will be the most stable throughout the week.
Again there is a big difference between one hitting a high-end/high trough FT injecting once weekly vs twice-weekly vs daily.
Most men are aiming for a high-end high trough FT without even blinking an eye when it comes to injection frequency.
Huge difference between one hitting a high FT 25-30 ng/dL injecting daily or EOD. vs once weekly.
You have guys running around with absurdly high trough/steady-state FT levels well beyond their natty genetic set-point.
The body was never meant to be amped up on T 24/7 steady-state.
You are hammering the s**t out of your dopamine and CNS.
Yes you can make the case that when using exogenous T there are numerous factors that can play a role in what levels are needed in order to experience relief/improvement of low-T symptoms and overall well-being.
Everyone reacts differently to hormones due to genetics/sensitivity of the AR (androgen receptor), sensitivity of the ER (estrogen receptor), polymorphism of the AR and CAG repeat length (short/long).
This is a given.
Yes there is such a thing as AR DDS (distribution, density, sensitivity/polymorphisms).
When it comes to sensitivity of the AR, polymorphism of the AR/CAG repeat length (long/short) tread lightly when you speak on such especially when it comes to those so called gurus/experts preaching that everyone and their brother needs to be running these high/absurdly high trough FT levels 30-60 ng/dL in order to experience the beneficial effects of T!
Hope you understand that three of those top experts Dr. Mohit Khera , Dr. Michael Zitzmann and Dr. Hugh Jones have tested a small number of their patients for CAG repeats (short/long) and hate to bust your bubble here but even in the men with the higher CAG repeats they did better with T levels in the HIGHER-NORMAL RANGE not SUPRA-PHYSIOLOGIC as in above/well above the upper limit.
Hope you understand that men with higher CAG repeats is not common.
Yes there are other things that come into play here when it comes to sensitivity of the AR but highly doubtful a man would need to be pushing their trough FT 40-60 ng//dL to overcome this.
The majority of men on therapy have never even needed to go well beyond the upper 1/3 and we are talking decades here!
Everyone caught up into thinking they need to be hitting high absurdly high troughs in order to experience relief/improvement in low-T symptoms let alone feel great overall!
It's a F**KING myth pushed by all those CLOWNS stinking up those so called men health/HRT forums!
You know those kiddie forums polluting the net!
Pure nonsense!
Seeing as it keeps going over your head here.
The reality of T physiology is thresholds, plateaus, and diminishing returns not a linear "more testosterone is better" dose-response.
T is a threshold hormone!
Main point here being start low and go slow titrate the dose if need be until the threshold is crossed (bloodwork + symptoms).
Symptoms improved while at the same time minimizing/avoiding sides, keeping blood markers healthy and maintaining long-term health is key here.
Crossing the threshold turns the lights on but cranking the dimmer switch past that doesn't make them shine brighter. It's a ceiling effect, not a linear dose-response.
Especially when it comes to libido and erectile function.
The majority of symptoms will be improved once you achieve a healthy FT which for most would be aiming for a healthy/high-end trough 15-25 ng/dL or better yet push it up to 30 ng/dL for all those BROZZZ!
Yes some will choose to run higher levels but the main benefit you are going to get here when driving up your FT sky-high is better gains in muscle/enhanced strength and recovery.
As I stated in one of my previous replies from this thread everyone of the top experts in the field that has been treating 1000s of men over decades (20-30 yrs) with VAST clinical experience and YEARS of RESEARCH in the field would tell you that the majority of men will do well on 100-150 mg T/week which would easily allow one to hit a healthy/high trough FT 15-30 ng/dL and more importantly relieve/improve every F**KING symptom of low-T.
Of course there will always be those outliers who would need the higher-end dose 200 mg T/week but they are few and far between.
The goal here would be to target the lowest effective dose that relieves symptoms and restores physiologic--->high-normal Free T trough levels (15-30 ng/dL).
The majority of low-T symptoms will be relieved/improved hitting a healthy trough FT as in 15-30 ng/dL or the upper 1/3rd.
With ease!
Again we are talking trough FT here!
Any expert truly in the know would tell you this.
You keep babbling on about reference ranges, genetics, blah, blah yet you seem to lack the understanding that all of those top experts would tell you its rare anyone would need to push a trough FT well beyond 30 ng/dL in order to relieve/improve every F**KING single symptom of low-T.
We are talking the majority here.
If you think one needs to hit these absurdly high trough FT levels to truly benefit from therapy then you need to give your head a shake and look elsewhere as T is not the problem here!
I and anyone truly in the know would tell you sleep, diet, exercise, thyroid/adrenals and stress (physical/mental) will have a far bigger impact when it comes to energy, mood, libido, erectile function and overall health than supposedly needing a high/absurdly high trough FT.
Plain and simple!
All that should really matter here is the dose one needs to achieve a healthy trough FT which will result in relief/improvement of low-T symptoms and overall well-being.
Yes symptom relief is what truly matters but when it comes to what FT level is needed one needs to keep in mind the overall goal would be to use the least amount in order to feel well while at the same time minimizing sides and keep blood markers healthy long-term.
Even if you threw the sides out the window and they were avoided when running higher levels the goal here was never to jack one up on T 24/7 steady-state.
Abe hitting the nail on the head here...RESTORATION OF ROBUST YOUTHFUL LEVELS!
Any man hitting a high trough FT is already well beyond robust youthful levels.
This needing to hit an absurdly high trough FT 40-60 ng/dL pushed by those sheep or so called gurus/experts is pure BULL S**T!
Again!
Coming from the guy who is highly regarded and would be considered the father of modern testosterone therapy.
He lectures all over the world!
Dr. Morgentaler
* what's important to understand though is that the concept of testosterone therapy in theory is designed to replicate youthful levels of testosterone to help people who are deficient in this hormone, the goal isn't to make them into supermen and the real question is why do people want to go above normal if at all, much of the concept of treating up lets say a 1000 let's say our normal upper limit, in the anti-aging community or age management community there are some people who believe the there's an optimal level of testosterone that may be 1200 or 1500 or even I've heard 1800 and the basis for that is WEAK!
Abe already toasted the myth that one needs to have high steady-state (24/7) or better yet a high trough FT in order to treat symptoms of low-T!
The newer oral TU formulations (Jatenzo, Tlando and Kyzatrex) put the f**king nail in the coffin here!
Dr. Morgentaler
Pros/Cons oral TU (51:24-57:12)
* one of the things that the orals have transformed is the concept that you have to have a continually high level of testosterone to get the benefits and clearly that's not true and the safety profile seems to be improved by having levels that fluctuate some during the day returning to close to or even baseline
*Optimal results often require T values in the upper range of normal (T 600-900 ng/dL)
What is that Abe?
Oh yeah, those so-called gurus (hint hint) claiming that everyone and their brother that they treat need to be running trough TT 1200-1800 ng/dL (or higher LOL) with sky-high FT to experience relief/improvement of low-T symptoms due to testosterone resistance let alone being cursed with that polymorphism of the AR/gene CAG repeat lengths >24.
Teflon testosterone-resistant BRUH, stricken with that longer CAG repeat length BRUH!
LMFAO!
Let that sink in your DOME!
*Some groups target T levels 1200-1800 ng/dL
*Supraphysiological/pharmacological rather than restoration of robust youthful levels
Have every lecture!
Link to some of them.
Excel is littered with AM!
vimeo.com
Link to some of them.
Excel is littered with AM!
Agri Meetings
Agri Meetings is a member of Vimeo, the home for high quality videos and the people who love them.
vimeo.com
Where are those trough TT 1000+ or 1500-2000 ng/dL with trough FT 40-60 ng/dL?
LMFAO!
Again the only men that would ever need to venture well beyond TT 1000 ng/dL would be the men with high SHBG!
* However some men won't achieve adequate response until total T in upper levels of normal 650-1000 ng/dL
Hitting the nail on the head here!
* The panel unpacks why “normal ranges” don’t fit every individual, highlighting genetic differences in androgen receptor sensitivity (CAG repeats) and the need to tailor treatment to symptoms and biology rather than numbers alone.
Hugh Jones laying it out for ya!
HIGHER NORMAL RANGE not SUPRA-PHYSIOLOGIC as in over/well over the upper-limit!
Take home point!
* We've also shown that when testosterone is given, if someone has a high CAG repeat, which is low sensitivity, they don't respond unless you get the testosterone in the HIGHER NORMAL RANGE.
4:20-6:07
* so we have been developing a blood test which is a testosterone CAG repeat ratio. So the higher your testosterone and your lower your CAG repeat you will have a higher sensitivity of androgenization. So that's how you can work it out. We've also shown that when testosterone is given, if someone has a high CAG repeat, which is low sensitivity, they don't respond unless you get the testosterone in the HIGHER NORMAL RANGE.
Dr. Zitzmann one of the true heavyweights in the field!
Worked under the grandmaster of testosterone the legendary Professor Eberhard Nieschlag!
* Dr. Michael Zitzmann, a prominent researcher in andrology and reproductive endocrinology, has made substantial contributions to elucidating the functional and clinical implications of the CAG trinucleotide repeat polymorphism in exon 1 of the androgen receptor (AR) gene on the X chromosome. This polymorphism encodes a variable polyglutamine tract in the AR protein's N-terminal domain, which inversely modulates the receptor's transcriptional activity: shorter repeats enhance AR transactivation, while longer repeats attenuate it, leading to subtle variations in androgen sensitivity even within normal testosterone ranges.
* CAG repeats, I would say, were discovered in the 90s and in fact that was one of my research areas the androgen receptors and also still when I started here at the university in Munster in 2001, the first research over many years was always about the androgen receptor. In fact, this field was also founded by me with a few people, of course, that we discovered it. That has a clinical significance, not every man is the same and not the testosterone level, you can't lump them all together
00:25:00 Androgen receptor: CAG repeats
* the androgen receptor has a gene that is located on the x chromosomes we get in men, so they were all supplied by our mother and there are areas that are different for each person called CAG repeats. The longer this area is in the gene, the larger the gap in the receptor where the testosterone can bind, so to speak. You can imagine this lock. It may also be a bit hard or worn out in some people where testosterone doesn't work as well in those where it fits exactly, you can't change it, it's genetically predetermined for us and if the body is healthy it regulates it on its own. If you now have a bad receptor, you also produce more testosterone, but of course someone can then slip into a testosterone deficiency if their receptor is not okay
* the receptor density by the way, is very difficult to measure, CAG repeats, I would say, were discovered in the 90s and in fact that was one of my research areas the androgen receptors and also still when I started here at the university in Munster in 2001, the first research over many years was always about the androgen receptor. In fact, this field was also founded by me with a few people, of course, that we discovered it. That has a clinical significance, not every man is the same and not the testosterone level, you can't lump them all together
* we don't always measure the CAG repeats, that's a genetic test, it's terribly expensive , cost around €300 and only has to be determined once in a lifetime because that doesn't change, but we don't do it routinely for every patient
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16.
Can see it now on all those bro forums everyone and their brother claiming that they need to be running absurdly high trough FT levels due to the sensitivity of the AR and being cursed with gene CAG repeat lengths >24.
LMFAO!
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16.
www.excelmale.com
...
LMFAO!
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16.
ExcelMale - #1 TRT & Testosterone Forum | Expert-Moderated Men's Health Community
As the mediator of androgen actions, the androgen receptor (AR) plays a central role in establishing both physical and behavioral sex differences. The AR gene contains a CAG repeat polymorphism that is related to the strength of androgen actions on target tissues and that is correlated with...
www.excelmale.com
The same applies to androgen receptor gene CAG repeat lengths >24 in the presence of symptoms and normal testosterone levels may be considered as a state of preclinical TD [93]
* In humans, the AR gene comes in many forms, called alleles. The best-studied alleles are those involving a CAG repeat sequence that encodes a polyglutamine tract near the amino end of the androgen receptor. This CAG repeat has different lengths for different people. In humans, the number of AR CAG repeats ranges from as few as 9 to as many as 36, but population averages are typically between 17 and 24 (Chamberlain et al., 1994; Hsiao et al., 1999; Irvine et al., 2000; La Spada et al., 1991). Individuals with higher numbers of AR CAG repeats will normally have diminished testosterone action on cellular functioning, effectively making males with high AR CAG repeats less masculine regarding most sexually dimorphic traits when compared to males with fewer AR CAG repeats (Loehlin et al., 2004; Simanainen et al., 2011)
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16. Five countries had averages in the 17.00s; they were Swaziland (17.00), Zambia (17.00), Sierra Leone (17.30), Nigeria (17.58), and Senegal (17.90). Five countries had averages of 23.00 or higher; they were Lithuania (23.00), Mongolia (23.00), Ireland (23.07), Thailand (23.10), and Romania (23.16).
A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long term consequences for health and wellbeing. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.
SpencerD6571
New Member
You obviously didn't watch his lecture. With increasing levels of androgens, the receptors up regulate, and with decreasing levels, they down regulate. Estrogen receptors do not up regulate. Testosterone has two those response curves, and the dose response curved for muscle is different than everyone else in the body. He explains the dose response curves for testosterone and estradiol in exhaustive detail. Look at the section where he talks about these dose response curves, and the fact that all hormones have have three zones, the deficiencies zone, the physiologic operating zone, and the saturation/plateau zone. This is the first lecture I've seen on testosterone that actually goes into detail on the physiology. Once again statements like yours are based on opinion and not on actual physiology or the medical literature. All benefits of testosterone for 91 years have been shown with normal testosterone to estradiol aromatization. It's obvious you didn't watch his lecture because all of the answers to your questions/statements are there. He specifically discussed his dosing and staying within the therapeutic window and below the maximum tolerated concentration above which you get side effects. Why don't you actually watch the lecture before you start commenting on a lecture that you obviously didn't watch. I've watched it three times and I've learned something every time that I've watched it. This is the most extensive testosterone lecture I've ever watched. Not to mention other very well respected doctor such as Dr. Andrew Winge echo what Dr. Nichols has been saying for years.
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"Sheep"?? If I were, I'd be a spineless piece of crap that wouldn't QUESTION ANYTHING! You'd seriously prefer myself and others to be sheep and not have any thoughts or opinions of our own. Sorry bud, that ain't me.Still babbling on about those reference ranges/guidelines LOL!
Starting to sound like all those other sheep!
Natty vs hypogonadal men on T therapy
Natty
Healthy functioning HPG-axis.
Every man has. a natty genetic set-point within the physiologic reference range other than those outliers as in men with high SHBG that would be hitting those 1000+ ng/dL T levels and even then depending on where their TT/SHBG sits its not a given that they are running around with a high peak FT.
Those natty men hitting that high peak FT would be those outliers.
Natural endogenous testosterone secretion is both pulsatile and diurnal.
Average daily production is 5-7 mg.
During the normal 24-hour circadian rhythm of a healthy young male T levels gradually rise overnight reach a peak in the early morning then decline throughout the day with lower levels in the late afternoon and a trough (lowest point) in the evening.
Fluctuations from peak--->trough are typically 20-25%
The daily morning peak is transient as in short-lived.
The men hitting those FT levels that fall in the upper limit of the reference range as in 25.3 ng/dL would be those outliers as in few and far between.
Those high values represent a transient morning peak not a level maintained throughout the day and sure as hell not a trough value.
There is a natural ebb and flow as the body was never meant to be AMPED up on T 24/7.
Hypogonadal on T therapy
Underlying HPG-axis dysfunction as in primary (testicular failure) or secondary (hypothalamic/pituitary dysfunction).
Treatment with exogenous T will result in a strong suppression of the HPG-axis.
LH stimulates the Leydig cells in the testes to produce ITT (intratesticular testosterone) and ITT/FSH stimulates the Sertoli/germ cells located inside the seminiferous tubule lobes to produce sperm.
When one uses exogenous testosterone/AAS it results in shut down of the HPG axis and the pituitary no longer secretes LH/FSH.
Lack of LH causes atrophy of the Leydig cells which are located between the seminiferous tubules and lack of ITT/FSH causes atrophy of the Sertoli/germ cells which are located inside the seminiferous tubules. The cells shrink and become dormant.
The body no longer produces endogenous testosterone and sperm production is halted.
The Leydig cells only make up 10-20% of testicular volume as oppose to the germ cells/seminiferous tubules (where sperm is produced) which make up almost 80% of the testicular volume so a majority of the shrinkage results from atrophy of the germ cells/seminiferous tubules.
Basically comes down to exogenous testosterone use results in significant suppression of spermatogenesis which leads to testicular shrinkage as a majority of teste volume is made up of germ cells located in the tightly bundled seminiferous tubule lobes where sperm is produced.
Not only does FSH stimulate sperm production but ITT alone is also playing a strong role.
Regarding the use of hCG we can take it along with trt to maintain fertility/prevent testicular shrinkage.
The use of hCG will mimic LH and result in stimulating the Leydig cells in the testes to produce ITT which will have a big impact on stimulating the Sertoli/germ cells located inside the seminiferous tubule lobes to produce sperm and this will cause an increase in testicular volume.
Even with exogenous T + hCG the hypothalamus and pituitary remain highly suppressed.
hCG bypasses the suppressed pituitary by mimicking LH at the testes but it does not restore normal GnRH, LH, or FSH secretion.
Top it off that T solo without the use of hCG may have a negative impact on our long-term overall health due to the negative impact on upstream hormones.
The role of gonadotropins in testicular and adrenal androgen biosynthesis pathways -insights from males with congenital hypogonadotropic hypogonadism on hCG/rFSH and on testosterone replacement (link thread end of post))
* A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long term consequences for health and wellbeing. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.
When using exogenous T the natural 24hr circadian rhythm is thrown out the window as no T modality other than the Androderm T-patch (evening application) would most closely mimic such.
Even daily TP would never mimic such.
Numerous formulations to choose from here whether (nasal, buccal, oral TU, transdermal (cream/gel), pellets, injectable esterified T).
The majority of men are using injectable esterified T and the most commonly used esters (TC/TE) which are basically interchangeable.
Again the majority of men on T can easily hit a healthy/high trough FT injecting 100-150 mg T especially when split into more frequent injections.
Some men can achieve stellar levels injecting 100 mg T/week especially when split into more frequent injections.
Always going to be those outliers that will who may need the higher-end dose 200 mg T/week but those men would be few and far between.
Depending on the protocol (dose/injection frequency) there can be an extreme difference between the peak--->trough.
Once weekly would result in a big swing between peak--->rough and blood levels will not be as stable throughout the week.
Increasing the injection frequency as in 3x weekly (M/W/F), 2x weekly (every 3.5 days), EOD or daily will clip the peak and bring up the trough and blood levels will be more stable throughout the week.
Injecting daily would result in a minimal peak--->trough and blood levels will be the most stable throughout the week.
Again there is a big difference between one hitting a high-end/high trough FT injecting once weekly vs twice-weekly vs daily.
Most men are aiming for a high-end high trough FT without even blinking an eye when it comes to injection frequency.
Huge difference between one hitting a high FT 25-30 ng/dL injecting daily or EOD. vs once weekly.
You have guys running around with absurdly high trough/steady-state FT levels well beyond their natty genetic set-point.
The body was never meant to be amped up on T 24/7 steady-state.
You are hammering the s**t out of your dopamine and CNS.
Yes you can make the case that when using exogenous T there are numerous factors that can play a role in what levels are needed in order to experience relief/improvement of low-T symptoms and overall well-being.
Everyone reacts differently to hormones due to genetics/sensitivity of the AR (androgen receptor), sensitivity of the ER (estrogen receptor), polymorphism of the AR and CAG repeat length (short/long).
This is a given.
Yes there is such a thing as AR DDS (distribution, density, sensitivity/polymorphisms).
When it comes to sensitivity of the AR, polymorphism of the AR/CAG repeat length (long/short) tread lightly when you speak on such especially when it comes to those so called gurus/experts preaching that everyone and their brother needs to be running these high/absurdly high trough FT levels 30-60 ng/dL in order to experience the beneficial effects of T!
Hope you understand that three of those top experts Dr. Mohit Khera , Dr. Michael Zitzmann and Dr. Hugh Jones have tested a small number of their patients for CAG repeats (short/long) and hate to bust your bubble here but even in the men with the higher CAG repeats they did better with T levels in the HIGHER-NORMAL RANGE not SUPRA-PHYSIOLOGIC as in above/well above the upper limit.
Hope you understand that men with higher CAG repeats is not common.
Yes there are other things that come into play here when it comes to sensitivity of the AR but highly doubtful a man would need to be pushing their trough FT 40-60 ng//dL to overcome this.
The majority of men on therapy have never even needed to go well beyond the upper 1/3 and we are talking decades here!
Everyone caught up into thinking they need to be hitting high absurdly high troughs in order to experience relief/improvement in low-T symptoms let alone feel great overall!
It's a F**KING myth pushed by all those CLOWNS stinking up those so called men health/HRT forums!
You know those kiddie forums polluting the net!
Pure nonsense!
Seeing as it keeps going over your head here.
The reality of T physiology is thresholds, plateaus, and diminishing returns not a linear "more testosterone is better" dose-response.
T is a threshold hormone!
Main point here being start low and go slow titrate the dose if need be until the threshold is crossed (bloodwork + symptoms).
Symptoms improved while at the same time minimizing/avoiding sides, keeping blood markers healthy and maintaining long-term health is key here.
Crossing the threshold turns the lights on but cranking the dimmer switch past that doesn't make them shine brighter. It's a ceiling effect, not a linear dose-response.
Especially when it comes to libido and erectile function.
The majority of symptoms will be improved once you achieve a healthy FT which for most would be aiming for a healthy/high-end trough 15-25 ng/dL or better yet push it up to 30 ng/dL for all those BROZZZ!
Yes some will choose to run higher levels but the main benefit you are going to get here when driving up your FT sky-high is better gains in muscle/enhanced strength and recovery.
As I stated in one of my previous replies from this thread everyone of the top experts in the field that has been treating 1000s of men over decades (20-30 yrs) with VAST clinical experience and YEARS of RESEARCH in the field would tell you that the majority of men will do well on 100-150 mg T/week which would easily allow one to hit a healthy/high trough FT 15-30 ng/dL and more importantly relieve/improve every F**KING symptom of low-T.
Of course there will always be those outliers who would need the higher-end dose 200 mg T/week but they are few and far between.
The goal here would be to target the lowest effective dose that relieves symptoms and restores physiologic--->high-normal Free T trough levels (15-30 ng/dL).
The majority of low-T symptoms will be relieved/improved hitting a healthy trough FT as in 15-30 ng/dL or the upper 1/3rd.
With ease!
Again we are talking trough FT here!
Any expert truly in the know would tell you this.
You keep babbling on about reference ranges, genetics, blah, blah yet you seem to lack the understanding that all of those top experts would tell you its rare anyone would need to push a trough FT well beyond 30 ng/dL in order to relieve/improve every F**KING single symptom of low-T.
We are talking the majority here.
If you think one needs to hit these absurdly high trough FT levels to truly benefit from therapy then you need to give your head a shake and look elsewhere as T is not the problem here!
I and anyone truly in the know would tell you sleep, diet, exercise, thyroid/adrenals and stress (physical/mental) will have a far bigger impact when it comes to energy, mood, libido, erectile function and overall health than supposedly needing a high/absurdly high trough FT.
Plain and simple!
All that should really matter here is the dose one needs to achieve a healthy trough FT which will result in relief/improvement of low-T symptoms and overall well-being.
Yes symptom relief is what truly matters but when it comes to what FT level is needed one needs to keep in mind the overall goal would be to use the least amount in order to feel well while at the same time minimizing sides and keep blood markers healthy long-term.
Even if you threw the sides out the window and they were avoided when running higher levels the goal here was never to jack one up on T 24/7 steady-state.
Abe hitting the nail on the head here...RESTORATION OF ROBUST YOUTHFUL LEVELS!
Any man hitting a high trough FT is already well beyond robust youthful levels.
This needing to hit an absurdly high trough FT 40-60 ng/dL pushed by those sheep or so called gurus/experts is pure BULL S**T!
Again!
Coming from the guy who is highly regarded and would be considered the father of modern testosterone therapy.
He lectures all over the world!
Dr. Morgentaler
* what's important to understand though is that the concept of testosterone therapy in theory is designed to replicate youthful levels of testosterone to help people who are deficient in this hormone, the goal isn't to make them into supermen and the real question is why do people want to go above normal if at all, much of the concept of treating up lets say a 1000 let's say our normal upper limit, in the anti-aging community or age management community there are some people who believe the there's an optimal level of testosterone that may be 1200 or 1500 or even I've heard 1800 and the basis for that is WEAK!
Abe already toasted the myth that one needs to have high steady-state (24/7) or better yet a high trough FT in order to treat symptoms of low-T!
The newer oral TU formulations (Jatenzo, Tlando and Kyzatrex) put the f**king nail in the coffin here!
Dr. Morgentaler
Pros/Cons oral TU (51:24-57:12)
* one of the things that the orals have transformed is the concept that you have to have a continually high level of testosterone to get the benefits and clearly that's not true and the safety profile seems to be improved by having levels that fluctuate some during the day returning to close to or even baseline
*Optimal results often require T values in the upper range of normal (T 600-900 ng/dL)
View attachment 57555
What is that Abe?
Oh yeah, those so-called gurus (hint hint) claiming that everyone and their brother that they treat need to be running trough TT 1200-1800 ng/dL (or higher LOL) with sky-high FT to experience relief/improvement of low-T symptoms due to testosterone resistance let alone being cursed with that polymorphism of the AR/gene CAG repeat lengths >24.
Teflon testosterone-resistant BRUH, stricken with that longer CAG repeat length BRUH!
LMFAO!
Let that sink in your DOME!
*Some groups target T levels 1200-1800 ng/dL
*Supraphysiological/pharmacological rather than restoration of robust youthful levels
View attachment 57556
Have every lecture!
Link to some of them.
Excel is littered with AM!
Agri Meetings
Agri Meetings is a member of Vimeo, the home for high quality videos and the people who love them.
Where are those trough TT 1000+ or 1500-2000 ng/dL with trough FT 40-60 ng/dL?
LMFAO!
Again the only men that would ever need to venture well beyond TT 1000 ng/dL would be the men with high SHBG!
* However some men won't achieve adequate response until total T in upper levels of normal 650-1000 ng/dL
View attachment 57557
Hitting the nail on the head here!
* The panel unpacks why “normal ranges” don’t fit every individual, highlighting genetic differences in androgen receptor sensitivity (CAG repeats) and the need to tailor treatment to symptoms and biology rather than numbers alone.
Hugh Jones laying it out for ya!
HIGHER NORMAL RANGE not SUPRA-PHYSIOLOGIC as in over/well over the upper-limit!
Take home point!
* We've also shown that when testosterone is given, if someone has a high CAG repeat, which is low sensitivity, they don't respond unless you get the testosterone in the HIGHER NORMAL RANGE.
4:20-6:07
* so we have been developing a blood test which is a testosterone CAG repeat ratio. So the higher your testosterone and your lower your CAG repeat you will have a higher sensitivity of androgenization. So that's how you can work it out. We've also shown that when testosterone is given, if someone has a high CAG repeat, which is low sensitivity, they don't respond unless you get the testosterone in the HIGHER NORMAL RANGE.
Dr. Zitzmann one of the true heavyweights in the field!
Worked under the grandmaster of testosterone the legendary Professor Eberhard Nieschlag!
* Dr. Michael Zitzmann, a prominent researcher in andrology and reproductive endocrinology, has made substantial contributions to elucidating the functional and clinical implications of the CAG trinucleotide repeat polymorphism in exon 1 of the androgen receptor (AR) gene on the X chromosome. This polymorphism encodes a variable polyglutamine tract in the AR protein's N-terminal domain, which inversely modulates the receptor's transcriptional activity: shorter repeats enhance AR transactivation, while longer repeats attenuate it, leading to subtle variations in androgen sensitivity even within normal testosterone ranges.
* CAG repeats, I would say, were discovered in the 90s and in fact that was one of my research areas the androgen receptors and also still when I started here at the university in Munster in 2001, the first research over many years was always about the androgen receptor. In fact, this field was also founded by me with a few people, of course, that we discovered it. That has a clinical significance, not every man is the same and not the testosterone level, you can't lump them all together
00:25:00 Androgen receptor: CAG repeats
* the androgen receptor has a gene that is located on the x chromosomes we get in men, so they were all supplied by our mother and there are areas that are different for each person called CAG repeats. The longer this area is in the gene, the larger the gap in the receptor where the testosterone can bind, so to speak. You can imagine this lock. It may also be a bit hard or worn out in some people where testosterone doesn't work as well in those where it fits exactly, you can't change it, it's genetically predetermined for us and if the body is healthy it regulates it on its own. If you now have a bad receptor, you also produce more testosterone, but of course someone can then slip into a testosterone deficiency if their receptor is not okay
* the receptor density by the way, is very difficult to measure, CAG repeats, I would say, were discovered in the 90s and in fact that was one of my research areas the androgen receptors and also still when I started here at the university in Munster in 2001, the first research over many years was always about the androgen receptor. In fact, this field was also founded by me with a few people, of course, that we discovered it. That has a clinical significance, not every man is the same and not the testosterone level, you can't lump them all together
* we don't always measure the CAG repeats, that's a genetic test, it's terribly expensive , cost around €300 and only has to be determined once in a lifetime because that doesn't change, but we don't do it routinely for every patient
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16.
Can see it now on all those bro forums everyone and their brother claiming that they need to be running absurdly high trough FT levels due to the sensitivity of the AR and being cursed with gene CAG repeat lengths >24.
LMFAO!
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16.
...ExcelMale - #1 TRT & Testosterone Forum | Expert-Moderated Men's Health Community
As the mediator of androgen actions, the androgen receptor (AR) plays a central role in establishing both physical and behavioral sex differences. The AR gene contains a CAG repeat polymorphism that is related to the strength of androgen actions on target tissues and that is correlated with...
The same applies to androgen receptor gene CAG repeat lengths >24 in the presence of symptoms and normal testosterone levels may be considered as a state of preclinical TD [93]
* In humans, the AR gene comes in many forms, called alleles. The best-studied alleles are those involving a CAG repeat sequence that encodes a polyglutamine tract near the amino end of the androgen receptor. This CAG repeat has different lengths for different people. In humans, the number of AR CAG repeats ranges from as few as 9 to as many as 36, but population averages are typically between 17 and 24 (Chamberlain et al., 1994; Hsiao et al., 1999; Irvine et al., 2000; La Spada et al., 1991). Individuals with higher numbers of AR CAG repeats will normally have diminished testosterone action on cellular functioning, effectively making males with high AR CAG repeats less masculine regarding most sexually dimorphic traits when compared to males with fewer AR CAG repeats (Loehlin et al., 2004; Simanainen et al., 2011)
* Based on a total sample of 57,826 males occupying 78 countries, the overall average number of AR CAG repeats was found to be 21.40. National averages ranged from 17.00 to 23.16. Five countries had averages in the 17.00s; they were Swaziland (17.00), Zambia (17.00), Sierra Leone (17.30), Nigeria (17.58), and Senegal (17.90). Five countries had averages of 23.00 or higher; they were Lithuania (23.00), Mongolia (23.00), Ireland (23.07), Thailand (23.10), and Romania (23.16).
A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long term consequences for health and wellbeing. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.
Crap, still babbling the same 'ol copy/pastes!?? LOL
You can waste your time carpet bombing every thread with relentless and redundant copy/pastes if you like. OR, you could address IN BRIEF the main point that you'd like someone to consider and you might make a MUCH stronger case for yourself. Instead of pissing people off and pushing them away!!
"Always and Never" are two words you should tread lightly with and consider before spewing them or others that represent; "All or None" scenarios on the topic of TRT.
No one ever said "ALL" guys or "Everyone" about anything AND especially Not me.
As you said above: "Seeing as this keeps going over your head here"... -I guess as long as this keeps going over YOUR head, I'll keep saying it; As long as Ref Ranges and #'s continue to prove to be inept, I'll continue to reference their UNRELIABILITY. Not sorry! This in fact, makes much or your arguments as questionable and unreliable as ANY of the very doctors you continually criticize with your needless condescending remarks.
There IS room for error here! And plenty of it. TRT is still evolving and everyone can't be WRONG! and everyone can't be right either. But, common sense tells me and every other sensible and rational reader out there; that many of the Doctors that you consider "In the Know" as well as, many of the ones you criticize and condemn, do actually have A PIECE OF THE PUZZLE. It's not Always or Never and certainly not just b/c you say so or try to brow beat with redundant copy/pastes.
HAPPY 4th!
madman
Super Moderator
The parts of the thread that are cut/paste is to hammer the point home as it keeps going over your head!
LOL!
If you wanna keep beating around the bush you will get picked apart.
Same old sob story with you guys!
All caught up on that so called optimized more T is better mentality nonsense.
Ranting and raving about reference ranges/guidelines yet always FAIL to mention that any expert truly in the know as in the numerous ones I named off would never use/rely on hard numbers as being set in stone especially when it comes to the lower limit/hypogonadal.
Even then when treating men for low-T they would tell you that one needs to tread lightly when it comes to the doctors as in the same ones you guys keep throwing under the bus that are caught up on keeping T levels within a set reference range as in physiological especially the upper limit as it would be expected that in the majority of cases of men using the most common modality injectable esterified T peaks are going to be supra-physiologic.
The s**t kicker here is any one of them would pick apart those so called gurus/experts that all those brainwashed sheep are dick riding you know those doctors claiming men need to be hitting these absurdly high trough FT levels in order to treat every symptom of low-T.
LMFAO!
Any doctor truly in the know would tell you that every symptom whether low libido, mild erectile dysfunction, decreased nocturnal/spontaneous erections, decreased energy/fatigue, depressed mood/poor concentration, reduced muscle bulk/increased adipose let alone overall health (cardiovascular, brain, bone/tendons, immune system, lnsulin sensitivity/ipids, and body composition) can easily be relieved/improved by achieving a healthy FT.
Any one of them would tell you that getting quality sleep, following a healthy diet, exercising (weight training/cardiovascular), thyroid/adrenals health and managing stress (physical/mental) would have. a FAR BIGGER IMPACT when it comes to energy, mood, libido, erectile function and overall health than supposedly needing a high/absurdly high trough FT.
This is a given!
The point being stressed here is those absurdly high trough FT levels are not needed.
The main benefit you are going to get here when driving up your FT sky-high is better gains in muscle/enhanced strength and recovery.
Anyone would tell you this!
Again!
Yes symptom relief is what truly matters and anyone truly in the know would tell you that the goal here would be to target the lowest effective dose that relieves symptoms and restores physiologic--->high-normal trough Free T levels (15-30 ng/dL).
They all stress that the majority of low-T symptoms will be relieved/improved pushing the trough FT in the upper 1/3rd.
Not this absurdly high trough FT levels these so called gurus/experts are touting!
Not a chance!
Seeing as it keeps going over your head here.
The reality of T physiology is thresholds, plateaus, and diminishing returns not a linear "more testosterone is better" dose-response.
Another true pioneer in the field!
DECADES in the GAME!
Listen closely and let that sink in your DOME!
36:30 Why TRT treatments may cause more harm than good
40:00 Testosterone replacement vs optimization
Dude, you're a Freaking broken record of Bullsh#t! Spewing the same lame brain chip on your shoulder non-sense.
Foolishly lumping me in with the same old sob story with you guys! ...All caught up on that so called optimized more T is better mentality nonsense. -talk about "penetrating your dome"?? Or "hammering the point home as it keeps going over your head" ??? ...You are as freaking lost as last years Easter egg. What's wrong with you?? (no, seriously what's wrong with you???)
I'm NOT "You guys". I'm NOT about "more T is better"... If I am SHOW ME! Show ME where I ever made any idiotic Hard line assertions about EITHER TT or More is better.
You even went off like a school girl about me bringing up TT as well before. I never said it was THEE WAY written in stone. I DID however make the statement that both FT AND TT are BOTH being used extensively and that TT references were even being made and used by Nelson Vergel (Author, Men's Health Expert...) right here ON THIS SITE!! and as long as this is continues, there is going to be CONFUSION AND CONTROVERSY! -Leading to debates.
"Ranting and raving about reference ranges/guidelines" Never Ranted. Much less like a lil school girl. (you) But, I did bring up an Article that YOU posted: The Fallacy of Clinical Laboratory Reference Ranges! Maybe you should read it or delete it. Cause it spells out EXACTLY what I have described with our current Pseudo Ranges and the issues from them..
"The point being stressed here is those absurdly high trough FT levels are not needed". Where did I EVER SAY THAT??? Where did I EVER support that?? -You need a good head shake buddy.
I think "Madman" describes you in general. Divorced much? Napoleon syndrome maybe?? Both?? If so, IDK. Just quit taking your sarcastic, fragile Superiority Complex out on anyone who doesn't see it or understand it like you do.
Does it sound like I'm "Beating around the bush"?? You wanna "pick me apart"??
How many of all those "In The Know" doctors ever mention YOUR name in their conversations?? How many of them are Name dropping The infamous Madman?? -Oh, wait! ya mean you're only human like the rest of us?? Hmmmm, -let that sink in your DOME!
Foolishly lumping me in with the same old sob story with you guys! ...All caught up on that so called optimized more T is better mentality nonsense. -talk about "penetrating your dome"?? Or "hammering the point home as it keeps going over your head" ??? ...You are as freaking lost as last years Easter egg. What's wrong with you?? (no, seriously what's wrong with you???)
I'm NOT "You guys". I'm NOT about "more T is better"... If I am SHOW ME! Show ME where I ever made any idiotic Hard line assertions about EITHER TT or More is better.
You even went off like a school girl about me bringing up TT as well before. I never said it was THEE WAY written in stone. I DID however make the statement that both FT AND TT are BOTH being used extensively and that TT references were even being made and used by Nelson Vergel (Author, Men's Health Expert...) right here ON THIS SITE!! and as long as this is continues, there is going to be CONFUSION AND CONTROVERSY! -Leading to debates.
"Ranting and raving about reference ranges/guidelines" Never Ranted. Much less like a lil school girl. (you) But, I did bring up an Article that YOU posted: The Fallacy of Clinical Laboratory Reference Ranges! Maybe you should read it or delete it. Cause it spells out EXACTLY what I have described with our current Pseudo Ranges and the issues from them..
"The point being stressed here is those absurdly high trough FT levels are not needed". Where did I EVER SAY THAT??? Where did I EVER support that?? -You need a good head shake buddy.
I think "Madman" describes you in general. Divorced much? Napoleon syndrome maybe?? Both?? If so, IDK. Just quit taking your sarcastic, fragile Superiority Complex out on anyone who doesn't see it or understand it like you do.
Does it sound like I'm "Beating around the bush"?? You wanna "pick me apart"??
How many of all those "In The Know" doctors ever mention YOUR name in their conversations?? How many of them are Name dropping The infamous Madman?? -Oh, wait! ya mean you're only human like the rest of us?? Hmmmm, -let that sink in your DOME!
Last edited:
madman
Super Moderator
Dude, you're a Freaking broken record of Bullsh#t! Spewing the same lame brain chip on your shoulder non-sense.
Foolishly lumping me in with the same old sob story with you guys! ...All caught up on that so called optimized more T is better mentality nonsense. -talk about "penetrating your dome"?? "Or hammering the point home as it keeps going over your head"??? ...You as freaking lost as last years Easter egg. What's wrong with you?? (no, seriously what's wrong with you???)
I'm NOT "You guys". I'm NOT about "more T is better"... If I did SHOW ME! Show ME where I ever made idiotic Hard line assertions about EITHER.
You even went off like a school girl about me bringing up TT as well. I never said it was THEE WAY written in stone. I DID however make the statement that both FT AND TT are BOTH being used extensively and that TT references were even being made and used by Nelson Vergel (Author, Men's Health Expert...) right here ON THIS SITE!! and as long as this is continues, there is going to be CONFUSION AND CONTROVERSY! -Leading to debates.
"Ranting and raving about reference ranges/guidelines" Never Ranted. Much less like a lil school girl. (you) But, I did bring up an Article that YOU posted: The Fallacy of Clinical Laboratory Reference Ranges! Maybe you should read it or delete it. Cause it spells out EXACTLY what I have described with our current Pseudo Ranges...
"The point being stressed here is those absurdly high trough FT levels are not needed". Where did I EVER SAY THAT??? Where did I EVER support that?? -You need a good head shake buddy.
I think "Madman" describes you in general. Divorced much? Napoleon syndrome maybe?? Both?? If so, IDK. Just quit taking your sarcastic, fragile Superiority Complex out on anyone who doesn't see it or understand it like you do.
Does it sound like I'm "Beating around the bush"?? You wanna "pick me apart"??
How many of all those "In The Know" doctors ever mention YOUR name in their conversations?? How many of them are Name dropping The infamous Madman?? -Oh, wait! ya mean you're only human like the rest of us?? Hmmmm, -let that sink in your DOME!
My reply in post #8 was to the OP yet in post #11 you went and ran your mouth!
Grow some balls and throw my name in there next time!
What's funny (peculiar) is; even on this site, much of the data (even posted by @Nelson Vergel) continues to support and reference TT #'s as the Gold standard or at least the standard for reference.
So, as long as there continues to be credible data supported by TT #'s AND FT #'s widely circulating, there is going to be confusion and debate among patients and peers. Which is unfortunate. Everyone on here wants to better understand TRT.
Most unfortunate is the judgement and perceived hierarchy sometimes handed down from those who share the FT is King opinion! I'm not debating either way. Cause either camp is validated by "Studies" and "data" and neither has been exalted as absolute.
Our Political landscape and Social Media is bad enough. I gotta wonder; does every aspect of our lives need to turn into an "Us or Them" mentality? As responsible adults now, do we need to continue the petty Middle school/High school peer pressure tactics? The sarcastic judgmental comments towards those who might not see things the same way? (especially on this ever evolving subject)
Everyone with Low T is on the same Team.
oraldate, I'm Not aiming this at you personally or at your above comment. I'm new on here and have noticed some very biased view points and conjecture at times, resulting in demeaning sarcasm.
That was beating around the bush!
You called me out here snakey f**king move!
Just hung yourself here.
You already knew what I was about when you set foot on here.
Was just a matter of time before your true colours came out.
Newbies still running your mouths you sound like a bunch of birds!
If you don't like it bounce otherwise bring your A game as in do your research or you're gonna get called out and picked apart on here.
You guys are always taking the same s**t.
Going to bring up that lame superiority bull s**t the same line everyone and their brother from the u know who camp whines about.
LMFAO!
Boo f**king hoo no one on here including me has ever claimed guru status!
Try harder next time!
That s**t your kicking is weak!
Same old sob story with you guys.
Madman this, madman that...f**king pathetic.
Especially that dime a dozen crew lurking in the back ground mumbling nonsense they know who they are.
Nothing but F**KING BACK ROUND NOISE on here!
Funny how the same guys that are always running their mouths are the same ones that keep coming back to the forum.
I bet there are even some that snake around behind the scenes as hidden guests still secretly reading my threads/posts!
We run in a different f**king lane over here champ!
You're not going to find any off this s**t I post up on here (latest research, lectures on T-therapy/men's health) on those kiddie forums you know bumnation, facepalm, I just don't geddit!
Im bringing the creme of the crop here.
Which camp are you in as you clearly seem confused!
Still caught up on that TT!
Where does your FT truly sit and I am talking trough here?
If you are hitting a trough TT close to 1000 ng/dL and you have low/lowish SHBG then your trough FT would be high!
Hitting a high-end or high trough TT means nothing without knowing where your trough FT sits.
Your trough FT could easily be over the upper limit 25.3 ng/dL as in beyond where those outliers that fall in the 97.5th percentile.
FWIW, I’ve never been close to 2000ng/dl. But, I can say without ANY hesitation for me personally, a trough near 1000 is MUCH closer to “Blue Sky, above the clouds” than 700’s. Hands down, without ANY question and that’s not even close to Supraphysiologic levels.
Phil Goodman
Well-Known Member
Lmao…. It never gets old seeing madman play tough guy on this forum.
Seagal
Well-Known Member
"A madman is someone who is mentally ill, acting completely irrational, or behaving in a wild, reckless, and dangerous way."
HAHAHA!! How fitting
You have a Big F'ing mouth, along with the "virtual credibility" of your "Super Moderator" BS title and the protection of your keyboard in mommy's basement. Don't ever tell a man to "get some balls" while hiding behind your keyboard.
Speaking of the title of "Super Moderator" cough, cough.... You are about THEE WORST Mod I have EVER witnessed. Your communication skills are primitive, undisciplined and spiteful at best. Your judgmental. condemning tactics are that of the Church NO ONE wants to go to. -That frustrating, suffocating feeling ya get from the churches or Members who act like that... Moderator Def: Primary role is to enforce community rules, facilitate orderly conversations...
So sorry I'm not one of your spineless crony's or minions, I'm the guy WITH ENUF BALLS TO SAY TO YOU WHAT MANY OTHERS ARE THINKING... Chew on that before you yell at your mom and kick the dog.
Still sound like I'm "Beating around the bush" keyboard warrior???
"Where does your FT truly sit and I am talking trough here?" I know what my TT, SHBG and FT levels are and have been for the past 10yrs. and still have every Lab. So sit down clown
"Which camp are you in as you clearly seem confused!" I'm not in ANY "camp" you freaking child! I'm an objective onlooker trying to make sense of all the endless theories, contradictions and debates surrounding this topic. I gave FunkOdyssey a Great platform to work with and explain his thoughts, and convictions and he responded like a mature grown up and established some excellent points and credibility with his efforts. -Not just to me. But, to any others who read his well presented views.
"Funny how the same guys that are always running their mouths are the same ones that keep coming back to the forum". "Nothing but F**KING BACK ROUND NOISE on here!" -OH, THE IRONY HERE! Let that sink into your shallow mind...
"We run in a different f**king lane over here champ!" "WE"?? "WE"??? -Mr. "I run solo", not in anyone's camp!?!? -how fitting, you ARE Nothing but F**KING back round noise!! Zip it... PS WTF is "BACK ROUND NOISE"!?!? Sounds kinda inbred to me. -Maybe that's why you're so mad all the time?? ...Just a guess
"Im bringing the creme of the crop here". -is that what uncle Ned said to you?? Just keep that "Back Round" boy and shut up... "Try harder next time!" -I'm sure you've heard that a lot too huh!?
There, there widdo maddy man don't throw a tantrum. Just tryin to make you laugh! LOL
"Just hung yourself here" OH, NO!! NO, NOT THAT!! AH GEE, ANYTHING BUT THAT SIR MADCOW! LOL
This has been tons of fun Madcow. I could do this ALL DAMN DAY! LOL But, I'd much rather you just stay in your own lane, SOLO (so low I can't hear you) and don't waste my time with any more of your useless sarcastic BS. Grow TF up or as you said BOUNCE. You've done enough damage here, go contaminate another forum.
PLEASE fwd this thread to Nelson Vergel so he may begin to witness your abuse of this site and your degradation of his name and credibility
Why does he have his patients on cream take their labs at peak, not both peak and trough?
If their peak is 40 ng/dL, what do you think their trough would be?
Also why do you disagree with him dosing cream twice a day?
Phil Goodman
Well-Known Member
wtf are you on about???
I’m not commenting on a lecture I didn’t watch, I commented on the video I was quoting. I figured the fact that I quoted that post would’ve made it obvious, but I guess it wasn’t obvious to you.
I think it’s hilarious you said “Estrogen receptors do not up regulate.” then went on to talk down to me about how I don’t know what I’m talking about.
If “everything is answered” in the lecture then perhaps you could share the studies
In the video I commented on (which you for some reason didn’t mention) he said that the feel good effects of trt come from estradiol predominantly. This is clearly not true… which I’m assuming you realize or else you wouldn’t have omitted that part from your post. Either that or you are so eager to tell me what I should and shouldn’t comment on that you forgot to mention it.
Can’t we all get along?
For me, the value of a public forum is the opportunity to learn from perspectives different from my own or those I favor. I welcome robust debate and intellectual pushback, but personal attacks just derail the conversation. Let's keep the focus on mutual learning and the topic at hand." You all have much to offer and in the end we are all looking for a better life.
FunkOdyssey
Seeker of Wisdom
He's a disciple of Dr. Neil Rouzier, and that's how Dr. Neil teaches that it should be tested. Cream can drop off very fast, and especially if you're only applying once daily, a trough measurement is going to be a very low level, even below your natural baseline.
With twice daily application, probably around 22-24 ng/dL. With once daily application, maybe 5-10 ng/dL or even less.
Once daily application can maintain some HPTA activity, which will certainly help prevent testicular atrophy, may maintain some meager level of natural testosterone production and fertility, and will cause less disruption to the cascade of 12+ hormones and neurosteroids disrupted by full HPTA shutdown. We think this may be associated with subjective benefits compared to full HPTA shutdown.
FunkOdyssey
Seeker of Wisdom
To me, the post reads like Dr. Nichols snuck back on here with a new account.
I've seen a lab test result from a guy using just 0.5g of a 100mg/g compounded cream to the inside of his forearms and his TT right before his next application the following morning was 21 nmol/L which is mid normal range.
Do those very low lab numbers on once a day dosing occur following scrotal application?
FunkOdyssey
Seeker of Wisdom
Total T isn't a useful assessment without SHBG to permit a free T calculation, and you also want to run LH to assess HPTA activity at trough with once daily application. Based on the dosage and the once daily, I would expect robust HPTA activity on his protocol which would be supporting the trough testosterone level.
I'm not aware of any difference in pharmacokinetics between scrotal and forearm application besides reduced overall absorption in many people with non-scrotal sites and certainly less DHT with non-scrotal.
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