T Levels Tanked on TRT?

[wannabefan]

Who is the endocrine expert here?

What is the clinical rationale as to why and how my T levels would drop within 1 month on 200mg transcrotal cream, YET DHT nearly tripled, LH went to 0 (as I’d expect), and HCt went up from 46 to 50?

Clearly the T cream was “working”, but T went from 502 to 186, and Free T paralleled that drop proportionately, but why?

Taking 50mg DHEA (level tripled) and 50-100mg Pregnenolone at same time; don’t know this had any impact. And on another tangent, I’m not clear the Backfill pathway logic flies.

Some say, move cream to back of knee or arm because of issues with holding T in scrotum? Split the doses? As if this would affect the lab reading? Labs done 2 hours post waking, and 22 hours post last application. Needle-phobic somewhat, hence cream.

I stopped T cold, reduced DHEA and Preg by 2/3, and T labs came back to pre-TRT within 85% after 28 days.LH came back 100% Estradiol came back 100% (18), BUT SHBG only came back 60% (now low at 19, was 32 before T).

Any takers?

 

[bixt]

22 hours post last application

Relax, everything is working as expected! That kind of level is to be expected 22 hours post application. Creams are probably better measured at peak, an hour or couple hours after application. This low trough is also why some apply a second dose later in the later.

Most importantly, how did you feel? Did you stop purely on the numbers or were you not feeling so good as well? Out of curiosity, how was your sleep on the cream?

 

[wannabefan]

Relax, everything is working as expected! That kind of level is to be expected 22 hours post application. Creams are probably better measured at peak, an hour or couple hours after application. This low trough is also why some apply a second dose later in the later.

Most importantly, how did you feel? Did you stop purely on the numbers or were you not feeling so good as well? Out of curiosity, how was your sleep on the cream?

 

[wannabefan]

Honestly, I felt very good before T, very little symptoms of any, lower libido than I’d like at 55 and fit for life.

On the troughing, if I have that low T overnight and hours into waking. It would seem T is being “soaked” up by testes, converting to DHT (I don’t convert to estrogen naturally fortunately), as DHT was 95, and I felt even better on the cream, regardless of time; couldn’t wait to get back to gym or with my wife.

But the numbers freaked me out, and I’ve been in life sciences for 30 years.

Was thinking of splitting doses between scrotum and arm/back of knee, BID?

Is there such a thing as micro-dosing so as to not shut off LH completely but still get the bump? Thoughts on concomitant DHEA and Preg supplementing or should I just see what T cream can do on its own? TY!

 

[wannabefan]

Honestly, I felt very good before T, very little symptoms of any, lower libido than I’d like at 55 and fit for life.

On the troughing, if I have that low T overnight and hours into waking. It would seem T is being “soaked” up by testes, converting to DHT (I don’t convert to estrogen naturally fortunately), as DHT was 95, and I felt even better on the cream, regardless of time; couldn’t wait to get back to gym or with my wife.

But the numbers freaked me out, and I’ve been in life sciences for 30 years.

Was thinking of splitting doses between scrotum and arm/back of knee, BID?

Is there such a thing as micro-dosing so as to not shut off LH completely but still get the bump? Thoughts on concomitant DHEA and Preg supplementing or should I just see what T cream can do on its own? TY!

Pharmacokinetics of testosterone cream applied to scrotal skin - PubMed

Scrotal skin is thin and has high steroid permeability, but the pharmacokinetics of testosterone via the scrotal skin route has not been studied in detail. The aim of this study was to define the pharmacokinetics of testosterone delivered via the scrotal skin route. The study was a...

pubmed.ncbi.nlm.nih.gov

PK levels for T and DHT via scrotal cream delivery.

 

[bixt]

I felt even better on the cream, regardless of time; couldn’t wait to get back to gym or with my wife.

But the numbers freaked me out, and I’ve been in life sciences for 30 years.

I would get back on that exact protocol!!

Just test at peak (2h, from your quoted study), and you will find the numbers are in all probability high.

Is there such a thing as micro-dosing so as to not shut off LH completely but still get the bump?

I know nasal gels and perhaps oral T undecanoate are capable of this. I'll leave LH expert @Cataceous to answer if this is possible with micro dosing creams.

 

[wannabefan]

Scrotal levels peak at 5 hours according to a PK study done in 2017 (tested 50 mg and 2 lower doses but curve to trough is similar).

If I split doses, 7A and 4P, was thinking that could work, perhaps 150mg, 2 clicks scrotal, 1 arm as DHT was 95 at 4 clicks. 3 clicks may also work and keep my HCt at 49, or so, as 4 was 50.2 in 1 month.

 

[Cataceous]

...
Is there such a thing as micro-dosing so as to not shut off LH completely but still get the bump? Thoughts on concomitant DHEA and Preg supplementing or should I just see what T cream can do on its own? TY!

...
I know nasal gels and perhaps oral T undecanoate are capable of this. I'll leave LH expert @Cataceous to answer if this is possible with micro dosing creams.

There's hard data showing that nasal gels accomplish this. Pharmacokinetic data suggest that troches could be similar. There's still some LH suppression, but apparently not enough to matter. Transdermal testosterone, injected testosterone esters, and oral testosterone undecanoate all have longer half-lives, which result in greater HPTA suppression. These longer-acting forms can always be dosed low enough to reduce the suppression, but then peak testosterone is reduced to the point of yielding no added benefit, at least for those suffering from secondary hypogonadism. It's a different story with primary, where you can tune your dose to achieve both normal serum testosterone and normal LH.

 

[Charliebizz]

Scrotal levels peak at 5 hours according to a PK study done in 2017 (tested 50 mg and 2 lower doses but curve to trough is similar).

If I split doses, 7A and 4P, was thinking that could work, perhaps 150mg, 2 clicks scrotal, 1 arm as DHT was 95 at 4 clicks. 3 clicks may also work and keep my HCt at 49, or so, as 4 was 50.2 in 1 month.

If you were doing 4 to the scrotum am. Why don’t you just split it 2am 2pm first before switching to other locations

 

[Systemlord]

I’m on Jatenzo which has a 6 hour half-life, if I check my levels 12 hours after dosing, I’ll see <300 ng/dL and peak levels 2-4 hours after dosing are 755 and 1052 ng/dL.

I dose Jatenzo twice daily @ 237 mg. I’ve tried Jatenzo once daily, it doesn’t work very well.

T-creamed is best dosed twice daily.

 

[wannabefan]

There's hard data showing that nasal gels accomplish this. Pharmacokinetic data suggest that troches could be similar. There's still some LH suppression, but apparently not enough to matter. Transdermal testosterone, injected testosterone esters, and oral testosterone undecanoate all have longer half-lives, which result in greater HPTA suppression. These longer-acting forms can always be dosed low enough to reduce the suppression, but then peak testosterone is reduced to the point of yielding no added benefit, at least for those suffering from secondary hypogonadism. It's a different story with primary, where you can tune your dose to achieve both normal serum testosterone and normal LH.

The peer reviewed data I have read showed PK for nasal is 40m-60m peak concentration, don't recall half life. Typically anything that peaks that soon, clears the body more slowly. I don't have either primary or secondary, per se, albeit my baseline T is 375-500, Free T 2% and LH 4.1.

 

[Vince]

there such a thing as micro-dosing so as to not shut off LH completely but still get the bump? Thoughts on concomitant DHEA and Preg supplementing or should I just see what T cream can do on its own? TY!

My notes on Empower nasal T gel experiment

I recently undertook a very unscientific 10 week experiment with Empower's nasal testosterone gel (similar to Natesto) to see if such a short-acting form of T could increase my baseline natural production. The idea is consistent with some of the Natesto studies that @madman has cited. NASAL T...

www.excelmale.com