Transdermals and DHT vs. Injections and DHT; Dr. Crisler on Surface Area of Gel Application

[Encore]

First of all, I just bought Nelson's Testosterone book and already read most of Dr. Crisler's book, so perhaps I'll find some more content related to this question as I finish reading them. Thank you Nelson for responding to my first thread here by the way. Your commitment to this forum is really commendable.

On to my question...I have seen a few mentions of gels causing higher DHT conversion, and that switching to injectable test lowered DHT levels for many people with roughly equivalent test levels. Dr. Crisler's book states that he prefers gels (and I realize that this could be patient dependent) because they lead to more variation in hormones throughout the day which we see in young, healthy men.

I'm just curious if there are studies comparing how gels v. injections affect DHT levels. This is obviously very relevant to men with thinning hair who would prefer not to rapidly bald on TRT.

I will note that Dr. Crisler's book mentions that there is evidence of less DHT conversion when higher concentration gels are applied to smaller surface areas of skin, but he suggests that there is no published study on this and it appears to be more anecdotal information.

 

[Nelson Vergel]

I would agree that gels (or creams) may generate more DHT than injections, specially if applied on the scrotum (ball sack). But DHT is what makes sex drive go up, so I would not limit its production in fear of losing hair.

Most of the hair loss in men occurs before we are 45. For those who still want to ensure no hair loss, generic Rogaine foam plus Nozoral shampoo use help.

I have not seen data on DHT production versus area of application of gels, but the speculation you mentioned makes sense to me.

 

[Encore]

I just checked Crisler again and I understand now. He speculates that there are more DHT receptors in the skin. Curious as to whether anyone is trying his suggestion of high concentration gels.

 

[Vince Carter]

Ive been pondering the link, if one exists, to sex drive and ED issues. I recently had mine tested and was @45% of lab max ranges. I was acne prone in my teens and young adult years and it's back with a vengeance but limited to my back and shoulders so I'm in a quandry with my DHT level. In some men and probably anecdotal evidence as noted, that transdermals fail in many ways for absorption and/or getting T levels in the higher ranges. But those men do feel better, reportedly feel better, and that's attributed to the DHT conversion in the TD application.

 

[Vince]

My Main fear of gels is spreading the testosterone to my lover, so I inject. I guess I'm fortunate that I have a strong libido with injecting T and hcg.

 

[Vince Carter]

I only disliked gel for the costs, it was astronomical even with insurance picking up 50%. I was paying $141 out of pocket for roughly 3 weeks of Androgel 1.62. Injections were/are FAR cheaper. I only ever got in the 500s on 3 pumps but admittedly I did feel an improvement from my Low T days. Never had an E2 test at that time and no AI being used, no HCG.

 

[roadglide]

Guys that switched from transdermals to injections did you notice a drop in libido and increased ED?

 

[CoastWatcher]

Guys that switched from transdermals to injections did you notice a drop in libido and increased ED?

Just the opposite. But I'm one of the many that failed to raise testosterone at all on topicals.

 

[GA8314]

My dad's DHT level became elevated to 3x normal limit with T cream from a compounding pharmacy. He has not noticed hair loss issues or increased urinary frequency or weakened stream. The cream DID increase his TT and fT very nicely to the upper normal range. E2 sensitive is normal and no AI being used currently.

Do I need to worry about his elevated DHT levels in the absence of an increased PSA or the above two symptoms he is NOT having?

He did dial down his dose but his TT and fT went down a lot and he felt better on the prior dose. I'm just not sure if I should be worrying about the 3x normal DHT levels or not.....

He likes creams and prefers that over injectables but I suppose he would consider injectables if DHT were a problem.

 

[ERO]

No need to worry with no increase in PSA and no symptoms.

 

[GA8314]

No need to worry with no increase in PSA and no symptoms.

I think you are correct. I've not seen studies implicating DHT as problematic for the most part.

Thus, I'm going to advise that unless he experience either elevated PSA, or a few aforementioned urinary/prostatic symptoms, then to go back to the dose he was at before.

Any other input? Nelson??? (Nelson I know you are the study guru....)

 

[PAUL-E]

I would agree that gels (or creams) may generate more DHT than injections, specially if applied on the scrotum (ball sack). But DHT is what makes sex drive go up, so I would not limit its production in fear of losing hair.

Most of the hair loss in men occurs before we are 45. For those who still want to ensure no hair loss, generic Rogaine foam plus Nozoral shampoo use help.

I have not seen data on DHT production versus area of application of gels, but the speculation you mentioned makes sense to me.

Has anyone tried injections with a low dose of gel/cream applied to their balls?

 

[Vince Carter]

Has anyone tried injections with a low dose of gel/cream applied to their balls?

I do this thru Dr Saya the last 6 months, I think. My DHT is now near or just above "max" lab values. Works great. Don't quote me but I think it's 25mg, T Cream daily to the scrotum. We made no changes to my TCyp injections dosing, my trough TT is in the 900-1000. No PSA issues and no detected hair loss at the scalp. It hasn't been the libido piece of the puzzle I was looking for though. Or maybe just a little. It wasn't a magic bullet for me.

 

[PAUL-E]

Thanks good to know, My concern with this would be transferring it to my wife or is there a "safe" time period after application?
sorry I don't mean to thread jack

 

[Helboi]

Thanks good to know, My concern with this would be transferring it to my wife or is there a "safe" time period after application?
sorry I don't mean to thread jack

I've been told after about an hour on the skin, most of it's been absorbed. Not sure how accurate that is or if I misunderstood.

 

[Vince Carter]

I don't have a transferrance issue, but just look at it this way, it's an AM application. You get dressed and head out for whatever your day entails. There shouldn't be a problem in the average persons day-to-day. I think this issue comes up like some other aspects of TRT in a negative light, they want you to be scared that your wife is going to grow a huge clit because she hugged you or some such nonsense.

 

[davidrn]

I do this thru Dr Saya the last 6 months, 25mg, T Cream daily to the scrotum. It hasn't been the libido piece of the puzzle I was looking for though. Or maybe just a little. It wasn't a magic bullet for me.

I have a question with your protocol, I have to get my DHT tested, but last year it was low. When I changed to T Cyp, I had a half dozen or so packets of the 10% AndroGel, and used them on the testicles. It really burned when I did this ( I do shave, maybe hair helps?), I only used about an ml or so at a time, but when I ran out after a week or so, didn't really notice a difference to libido, so didn't pursue this any further. I get 10ml of T Cyp at a time thru my Urologists contact at a compounding pharmacy, and pay cash, so i can get AndroGel for a copay, if I thought it might help. Anyone have an idea of how long it might take with this application to increase DHT?

 

[Vince Carter]

I never used androgel to the srotum, that's a hefty dose at just one pump IIRC. and also correct it's ill-advised with the alcohol content causing a burn sensation with sensitive skin there. In this application it's used daily, in my case, anyway. Testing has shown I'm low if I don't apply it that morning prior to testing. As long as I apply it say two hours before testing, then my DHT is nice and high so I've deduced that it works rather quickly and daily required.

 

[bigfred32]

I used TD for couple years. No matter how careful we were still had transference issues with my wife which started to cause her some hormonal issues.
TD tripled my DHT and I had to keep an eye on hematocrit and donate regularity.
Since I switched to inj the DHT lowered, hadn't had to donate blood yet and TT runs in the 1000 range consistent and transference ceased.
I had DHT in the high 100's to low 200's for a long time without any side effect issues.
My doctor was never concerned about it and neither was I.

 

[ERO]

I've been told after about an hour on the skin, most of it's been absorbed. Not sure how accurate that is or if I misunderstood.

This is correct, which makes me wonder how one would transfer to the wife if, for example, one showered in the AM, applied the T cream or gel and then went to work. Weekends could be a potential issue, but it would seem fairly easy to work around. Wash hands after application, etc...