Examing TRT - address root causes

[hardasnails1973]

Here is a exerpt i found about marianos post that may help alot of people with looking at specific areas first before going to TRT..


Thoughts I have would be:
1. Why reduce estradiol with arimidex when estradiol can be reduced by reducing the dose of depo-testosterone or by dividing the dose and giving more frequent injections - all to reduce high testosterone levels which causes more conversion of testosterone to estradiol?
2. Reducing estradiol results in higher thyroid hormone activity. Higher thyroid hormone activity can worsen adrenal fatigue (and depression and fatigue as a result), particularly when the adrenal glands are not healthy enough to tolerate high thyroid hormone levels.
3. Should the testosterone dose be reduced given the conversion to estradiol and testosterone's ability to worsen ongoing adrenal fatigue?
4. In a person with a complex problem, mental illness and high sensitivity to problems in treatment, if I had to start treatment over, it would be in this order:

First treat adrenal fatigue. This would include a serotonergic medication to treat depression and to reduce the perception of stress - thus protecting the adrenal glands from stress.

Second, after about a week of adrenal treatment, start treating hypothyroidism. Adjust thyroid hormone until energy level is maximized. Give the adrenal glands time to improve - approximately 6 months. The additional thyroid hormone, itself, will help strengthen adrenal function. Do final adjustments of thyroid hormone level. The person should have then normal or near normal energy and a significant reduction in depression.

Third, start introducing testosterone treatment, while controlling estrogen if necessary. This would then further improve mood and address sexual dysfunction. Sexual dysfunction itself may be reduced once adrenal and thyroid function is optimized. The initial treatment of adrenal fatigue and hypothyroidism sets the groundwork for testosterone treatment. It makes it easier also to use lower doses of testosterone to achieve a sense of well-being, while minimizing side effects such as from excessive estradiol levels.

Fourth, if depression is primarily a result of hormone imbalances, then an attempt to reduce the serotonergic antidepressant may be considred. If depression involves brain dysfunction, then the antidepressant treatment need to continue, though the dose might be reduced if possible without recurrence of depression.

 

[JanSz]

Here is a exerpt i found about marianos post that may help alot of people with looking at specific areas first before going to TRT..


Thoughts I have would be:
1. Why reduce estradiol with arimidex when estradiol can be reduced by reducing the dose of depo-testosterone or by dividing the dose and giving more frequent injections - all to reduce high testosterone levels which causes more conversion of testosterone to estradiol?
2. Reducing estradiol results in higher thyroid hormone activity. Higher thyroid hormone activity can worsen adrenal fatigue (and depression and fatigue as a result), particularly when the adrenal glands are not healthy enough to tolerate high thyroid hormone levels.
3. Should the testosterone dose be reduced given the conversion to estradiol and testosterone's ability to worsen ongoing adrenal fatigue?
4. In a person with a complex problem, mental illness and high sensitivity to problems in treatment, if I had to start treatment over, it would be in this order:

First treat adrenal fatigue. This would include a serotonergic medication to treat depression and to reduce the perception of stress - thus protecting the adrenal glands from stress.

Second, after about a week of adrenal treatment, start treating hypothyroidism. Adjust thyroid hormone until energy level is maximized. Give the adrenal glands time to improve - approximately 6 months. The additional thyroid hormone, itself, will help strengthen adrenal function. Do final adjustments of thyroid hormone level. The person should have then normal or near normal energy and a significant reduction in depression.

Third, start introducing testosterone treatment, while controlling estrogen if necessary. This would then further improve mood and address sexual dysfunction. Sexual dysfunction itself may be reduced once adrenal and thyroid function is optimized. The initial treatment of adrenal fatigue and hypothyroidism sets the groundwork for testosterone treatment. It makes it easier also to use lower doses of testosterone to achieve a sense of well-being, while minimizing side effects such as from excessive estradiol levels.

Fourth, if depression is primarily a result of hormone imbalances, then an attempt to reduce the serotonergic antidepressant may be considred. If depression involves brain dysfunction, then the antidepressant treatment need to continue, though the dose might be reduced if possible without recurrence of depression.

Excellent summary.
Post link to his web site.
What is the frequency of Depo-Testosterone shots that he recomends?

I think SubQ T shots (into fat) should release even slower further reducing spikes (good for E levels).

 

[hardasnails1973]

Excellent summary.
Post link to his web site.
What is the frequency of Depo-Testosterone shots that he recomends?

I think SubQ T shots (into fat) should release even slower further reducing spikes (good for E levels).

i am beginning to think people with untrreated hypothyroid doing 1/2 inch shots may be at risk for increasing possible e2 due to the thick mucouis layer between the skin which could be responsible for elevated e2 and DHT levels alot are expereincing. My e2 and DHT should have came down but they actually went up ward with possible more injection, but tuesday we will see where I lay..

 

[JanSz]

i am beginning to think people with untrreated hypothyroid doing 1/2 inch shots may be at risk for increasing possible e2 due to the thick mucouis layer between the skin which could be responsible for elevated e2 and DHT levels alot are expereincing. My e2 and DHT should have came down but they actually went up ward with possible more injection, but tuesday we will see where I lay..

How often you do your T shots?

 

[KSman]

I had E2=37, which was making a mess of things, with EOD injections. The 28mg EOD test cyp injections probably yield very even T levels.

For some, E will remain a problem even with more frequent injections and will require an AI to be managed effectively.

 

[hardasnails1973]

How often you do your T shots?

every 3days if you tihnk about it more esposure to subcutaneous fat and with my thyroid problem I still think that this could act the same way as with the gels possiby just a theory

last thyroid test with 12,5 mcgs t-3 morning and 8 hours later
ft4 .6 .8-1.8
ft 2.9 - 2.3 - 4.2
reverse t3 is below half which is good
Now it might be to start with armour and abring t-4 up slowly and see if reverse t-3 woudl creep up. REverse t-3 only dropped with increase of testosterone and possible estrogen management I could not explain why
time released t-3 did nothing

 

[hardasnails1973]

I had E2=37, which was making a mess of things, with EOD injections. The 28mg EOD test cyp injections probably yield very even T levels.

For some, E will remain a problem even with more frequent injections and will require an AI to be managed effectively.

KSMAN I am Beginning to see that..If the jackass would have ran the right e2 test first time I think this 8 week delay could have been avoided. With dosing 2 week shots (60 mgs moday and thusday with 250 ius hcg day prior with .5 armidex day of injection) I think I was rigth on target with e2 and still could go down alittle more even. Since shbg was up was telling me estrogen (estrone) was in play as well. it was less exposure to subcutanous fat. I think people with thyroid un resolved problems may be need to go once or twixe a week untill thyroid issues are resolved. By getting my thyroid back to par I think e2 and DHT problems will resolve them selfves. I never had thick skin in my life like i do now ..

Theory
Possible undertreated thyroid problem may expse people to same problem as gels with 1/2 inch injection, Once those thyroid porblems are resolved then e2 and dht may radical drop and e2 mangament may not be as needed as much..I will report my results tuesday on 3 days of 50 mgs STRAIGHT test E with hcg 250 ius hcg day before armidex .25 armidex day of injection. with last e2 of 73 with no anti E makes me suspicious this is enough armidex since I am having all the lovely signs of high e2 again...

 

[JanSz]

every 3days if you tihnk about it more esposure to subcutaneous fat and with my thyroid problem I still think that this could act the same way as with the gels possiby just a theory

last thyroid test with 12,5 mcgs t-3 morning and 8 hours later
ft4 .6 .8-1.8
ft 2.9 - 2.3 - 4.2
reverse t3 is below half which is good
Now it might be to start with armour and abring t-4 up slowly and see if reverse t-3 woudl creep up. REverse t-3 only dropped with increase of testosterone and possible estrogen management I could not explain why
time released t-3 did nothing

Going by the range you went to LabCorp, I am assuming you mistyped FreeT3.
ft4 .6 .8-1.8
ft 2.9 - 2.3 - 4.2

so your FreeT3=2.9(2.3-4.2)

Man you are so low on FreeT3 is not even funny.
I had exactly same 2.9
Ended on 3grains of Armour
First I went up to 4 grains with out feeling much difference except my body temperatures got to back to normal and sometimes I would have resting pulse up to 80bpm.
My April/07 blood test

FreeT3=4.86(2.3-4.2)
I backed down to 3grains.
Actually I did mine at Quest, they write theirs like this
T3 Free 486 (230-420)pg/dL

Keep Cortef at hand when you ramping up on Armour.

 

[hardasnails1973]

Going by the range you went to LabCorp, I am assuming you mistyped FreeT3.
ft4 .6 .8-1.8
ft 2.9 - 2.3 - 4.2

so your FreeT3=2.9(2.3-4.2)

Man you are so low on FreeT3 is not even funny.
I had exactly same 2.9
Ended on 3grains of Armour
First I went up to 4 grains with out feeling much difference except my body temperatures got to back to normal and sometimes I would have resting pulse up to 80bpm.
My April/07 blood test

FreeT3=4.86(2.3-4.2)


I backed down to 3grains.
Actually I did mine at Quest, they write theirs like this
T3 Free 486 (230-420)pg/dL

Keep Cortef at hand when you ramping up on Armour.

Yes I know i will raise thyroid up slowly because i have to watch for rt3 if they creep back up they are in mid range where they are suppose to be. And I think my severe thyroid problem is what is causing problems with Dht and e2 conversion due to 1/2 inch test injections and conversions happeing with armotase at the skin. using cortef 20 mgs a day

 

[pmgamer18]

Here I just found this at MESO from Dr. Marianco
===============================================
The top dose for Armour Thyroid is 300 mg a day (about 5 grain). If a person is still having problems at this dose, then it is highly important to evaluate for other causes of his/her symptoms. For example, are there other contributing factors such as an inability to activate T4 to T3 due to problems with the deiodinase enzymes? Is adrenal fatigue significant so that it interferes with the activation of thyroid hormone? It is important to get follow up evaluations and have good parameters to measure because a person should avoid hyperthyroidism since it risks atrial fibrillation and congestive heart failure, among other effects.

IsoCort may be too mild for many people with adrenal fatigue - and costly when very high doses are used. Appropriate doses of Hydrocortisone, Medrol, Prednisolone, or even Prednisone may be necessary to use instead.

Ideally (though the world is not ideal), treatment of hypothyroidism and adrenal fatigue is done before testosterone replacement (particularly in a person with testosterone over 400 ng/dl). When thyroid hormone and adrenal hormone activities are optimized, sex drive, fatigue, depression, and other problems can improve significantly even with low testosterone levels. What a physician does will, of course, depend on a person's condition and situation. The treatment has to be customized to the person.
__________________
Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please make an appointment. Thank you.
_________________
Men's Thyroid Co-Moderator and Hypopituitary Issues Co-Moderator.

 

[hardasnails1973]

Here I just found this at MESO from Dr. Marianco
===============================================
The top dose for Armour Thyroid is 300 mg a day (about 5 grain). If a person is still having problems at this dose, then it is highly important to evaluate for other causes of his/her symptoms. For example, are there other contributing factors such as an inability to activate T4 to T3 due to problems with the deiodinase enzymes? Is adrenal fatigue significant so that it interferes with the activation of thyroid hormone? It is important to get follow up evaluations and have good parameters to measure because a person should avoid hyperthyroidism since it risks atrial fibrillation and congestive heart failure, among other effects.

.

IsoCort may be too mild for many people with adrenal fatigue - and costly when very high doses are used. Appropriate doses of Hydrocortisone, Medrol, Prednisolone, or even Prednisone may be necessary to use instead.

Ideally (though the world is not ideal), treatment of hypothyroidism and adrenal fatigue is done before testosterone replacement (particularly in a person with testosterone over 400 ng/dl). When thyroid hormone and adrenal hormone activities are optimized, sex drive, fatigue, depression, and other problems can improve significantly even with low testosterone levels. What a physician does will, of course, depend on a person's condition and situation. The treatment has to be customized to the person.
__________________
Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please make an appointment. Thank you.
_________________
Men's Thyroid Co-Moderator and Hypopituitary Issues Co-Moderator.

Yes I agree 100% 3 years ago when first getting sick I went into endo saying adrenal fatigue end up walking out with script for paxil and trip to shrink. Upon further evlaltion I have been doomed probably from the start with cholesterols never excesding 140 my whole life so it was just amtter of time. Now I am investigating estrogen imblances which is off setting my copper serum levels. I beleive once I get my e2 stabile for a good long while then my other blood levels will come up (homocystein, triglycerides, cholesterol)

 

[pmgamer18]

Yes I agree 100% 3 years ago when first getting sick I went into endo saying adrenal fatigue end up walking out with script for paxil and trip to shrink. Upon further evlaltion I have been doomed probably from the start with cholesterols never excesding 140 my whole life so it was just amtter of time. Now I am investigating estrogen imblances which is off setting my copper serum levels. I beleive once I get my e2 stabile for a good long while then my other blood levels will come up (homocystein, triglycerides, cholesterol)

Yes I feel your right high E2 mess's up a lot of things in a man. I had a bad rash that came and went that left big red marks on the back of my legs. This itched bad but yet if you touch it it hurt big time. Every kind of Dr. and alot of meds never helped it. Yet I get my E2 down and the rash is gone.

 

[hardasnails1973]

Yes I feel your right high E2 mess's up a lot of things in a man. I had a bad rash that came and went that left big red marks on the back of my legs. This itched bad but yet if you touch it it hurt big time. Every kind of Dr. and alot of meds never helped it. Yet I get my E2 down and the rash is gone.

Well dr switched me to a new vitamin with copper in it and all I can say it was a copmlete night mare. Stop it for 3 days back to normal. Estrogen controls copper metabolism. Copper must locked in tissue and unbioavaible to the body due to adrenal fatigue so I have excess and and when e2 goes high holy cow everything is amplied 2 times over because it gets released into the blood stream.. I am going to focus on e2 and forget shbg for a while and once e2 stabilize shbg shoudl come down as well

 

[pmgamer18]

Well dr switched me to a new vitamin with copper in it and all I can say it was a copmlete night mare. Stop it for 3 days back to normal. Estrogen controls copper metabolism. Copper must locked in tissue and unbioavaible to the body due to adrenal fatigue so I have excess and and when e2 goes high holy cow everything is amplied 2 times over because it gets released into the blood stream.. I am going to focus on e2 and forget shbg for a while and once e2 stabilize shbg shoudl come down as well

Thats all I do keep my Total and Free levels up into the upper 1/3 of my labs range and keep my E2 down all the rest will follow.

 

[JesusReagan]

First treat adrenal fatigue. This would include a serotonergic medication to treat depression and to reduce the perception of stress - thus protecting the adrenal glands from stress.

I have been taking 100 mg/day of Zoloft for 5 years. I have a panic disorder, started when I was 25. I won't go into the long story of the years & years I spent trying to find a solution. Suffice to say, Zoloft works very, very well for me, and I won't go off of it - no way. My question - is taking the Zoloft addressing adrenal fatigue as you suggest above? Is Zoloft what you would consider a serotonergic medication? Also, I am naturally curious as to the contribution, if any, Zoloft has had to my low test issues.

 

[hardasnails1973]

First treat adrenal fatigue. This would include a serotonergic medication to treat depression and to reduce the perception of stress - thus protecting the adrenal glands from stress.

I have been taking 100 mg/day of Zoloft for 5 years. I have a panic disorder, started when I was 25. I won't go into the long story of the years & years I spent trying to find a solution. Suffice to say, Zoloft works very, very well for me, and I won't go off of it - no way. My question - is taking the Zoloft addressing adrenal fatigue as you suggest above? Is Zoloft what you would consider a serotonergic medication? Also, I am naturally curious as to the contribution, if any, Zoloft has had to my low test issues.

Root cause is probably adrenal and underactice thyroid that been untreated properly ...

 

[JesusReagan]

Root cause is probably adrenal and underactice thyroid that been untreated properly ...

This is the result of my thyroid panel:

Thyroid Reflex Panel
TSH: 3.069 uIU/mL scale: .350-5.500

looks like I'm 'mid-range', but I don't know what that means. This panel was taken a couple of weeks ago.

 

[engival]

hardnail, is shippen helping you treat your thyroid ?

 

[JanSz]

Well dr switched me to a new vitamin with copper in it and all I can say it was a copmlete night mare. Stop it for 3 days back to normal. Estrogen controls copper metabolism. Copper must locked in tissue and unbioavaible to the body due to adrenal fatigue so I have excess and and when e2 goes high holy cow everything is amplied 2 times over because it gets released into the blood stream.. I am going to focus on e2 and forget shbg for a while and once e2 stabilize shbg shoudl come down as well

You are complaining so much about your estrogen.
Next time you do blood test make sure you have this list completed at Quest, and do not listen to any arguments that some of them are inaccurate, some useless and so on:
61 Progesterone
62 Pregnenolone
63 Estradiol, Bioavailable
64 Estradiol, Free
65 Estradiol, Fractionated, serum
66 Estradiol, Ultra-sensitive (is part of fractionated)
67 Estrone,serum (is part of fractionated)
68 Estrogens, Total, Serum
69 Testosterone, Free, Bio/Total (LC/MS/MS)
70 Testosterone Total (included in T panel)
71 Testosterone Free(included in T panel)
72 Testosterone Bioavailable(included in T panel)
73 SHBG(included in T panel)
74 Albumin, serum(included in T panel)
75 Dihydrotestosterone DHT

 

[Scottyo]

This is the result of my thyroid panel:

Thyroid Reflex Panel
TSH: 3.069 uIU/mL scale: .350-5.500

looks like I'm 'mid-range', but I don't know what that means. This panel was taken a couple of weeks ago.

Your hypo. The new range on the TSH scale is to 2 or 2.5, and no longer 5.5. But many doctors don't know it. Even still, TSH is a pretty piss poor test to check out the thyroid...
you need free t3 and free t4 checked.

And often the underlying cause of low thyroid is tied to low adrenals.

 

[hardasnails1973]

This is the result of my thyroid panel:

Thyroid Reflex Panel
TSH: 3.069 uIU/mL scale: .350-5.500

looks like I'm 'mid-range', but I don't know what that means. This panel was taken a couple of weeks ago.

you need ft3 and ft4 tsh is a good gauge but even people under 2 can be hypo..

 

[pmgamer18]

First if you have a high E2 treat this first then do the Adrenals when they are supported now treat the thyroid with armour.

 

[hardasnails1973]

First if you have a high E2 treat this first then do the Adrenals when they are supported now treat the thyroid with armour.

phil is right treat the e2 and it should releive some stress on adrenal and thyroid.

JAnsz
I am getting the estroessence test from Genova when i get back from vacation and that will also show me if my liver is methyating right or not..Blood tests are pending should have results tommorrow. Getting my e2 stabilized is my priority.
Dr just put me on 50 mgs pregenlone cream to start. Started back on half grain of armour to bring up my t-4 that were in the crapper. Hopefully my reverse t-3 do not rise up again..
Up to 1500 mgs of magensium day and still no diarhea my WBC test should border line low mag which niecly refeclected my dhea a few months ago low out of range. Intracellular magneisum is a nice reflection of dhea levels..

 

[JanSz]

phil is right treat the e2 and it should releive some stress on adrenal and thyroid.

JAnsz
I am getting the estroessence test from Genova when i get back from vacation and that will also show me if my liver is methyating right or not..Blood tests are pending should have results tommorrow. Getting my e2 stabilized is my priority.
Dr just put me on 50 mgs pregenlone cream to start. Started back on half grain of armour to bring up my t-4 that were in the crapper. Hopefully my reverse t-3 do not rise up again..
Up to 1500 mgs of magensium day and still no diarhea my WBC test should border line low mag which niecly refeclected my dhea a few months ago low out of range. Intracellular magneisum is a nice reflection of dhea levels..

Double the dose of pregnenolone cream.
If it is like mine, 100mg/1gram, take 1gram/day

your ft3=2.9 - (2.3 - 4.2)

Go up to 3grains of Armour, 1/2 grain is just start.

 

[hardasnails1973]

Yes I know its just a start, but also I have 25 mcgs of t-3 a day that worked great for driving down the reverse t-3. Adding in armour slowly to see if my rt3 start to rise again after 3-4 weeks supporting with cortef 15-20 mgs a day depending on activaty levels. Waiting on blood test to come back to see where e2 is at then I will go from there. If e2 is high will the preg cream cause it to go any higher that is the question. Since swithcing test bases my e2 seems to have leveled off a bit so we will see in blood test and go from there. From stopping sustenon 3 -4 weeks ago it seems that that rollercoaster ride is over..

Goal
tt = 800-1000
shbg 20-25
e2 20-25
bioavaible 70-80%

currently
45 mgs testosterone every 3 days
arrmidex depends on lab work pending (was .25 mgs every 3 days)
1/4 grain armour/12.mcgs t-3 split 2 times a day 8 hours apart
15-20 mgs cortef depending on activity level..
30 mgs dhea
adding pregenolone creame starting at 50 mgs increasing as I go

 

[JanSz]

Yes I know its just a start, but also I have 25 mcgs of t-3 a day that worked great for driving down the reverse t-3. Adding in armour slowly to see if my rt3 start to rise again after 3-4 weeks supporting with cortef 15-20 mgs a day depending on activaty levels. Waiting on blood test to come back to see where e2 is at then I will go from there. If e2 is high will the preg cream cause it to go any higher that is the question. Since swithcing test bases my e2 seems to have leveled off a bit so we will see in blood test and go from there. From stopping sustenon 3 -4 weeks ago it seems that that rollercoaster ride is over..

Goal
tt = 800-1000
shbg 20-25
e2 20-25
bioavaible 70-80%

currently
45 mgs testosterone every 3 days
arrmidex depends on lab work pending (was .25 mgs every 3 days)
1/4 grain armour/12.mcgs t-3 split 2 times a day 8 hours apart
15-20 mgs cortef depending on activity level..
30 mgs dhea
adding pregenolone creame starting at 50 mgs increasing as I go

With SHBG 20-25
tt = 800-1000
is a correct level to achieve FreeT=250 (desirable upper range)
In order to achieve TT=1000
assuming that testis are not working
one need to get 140mg Depo-T dose weekly
that would make E3D dose
140/7*3=60mg per shot, 30units on insuline syringe.
Since you are using 45mg, which is less, the difference must be made up by your testis.
If your testis are working properly you must support them carefully.
I am not sure if E3D hcg shots are not spaced too far, possibly E2D is need.

 

[plymouth city]

Double the dose of pregnenolone cream.
If it is like mine, 100mg/1gram, take 1gram/day

your ft3=2.9 - (2.3 - 4.2)

Go up to 3grains of Armour, 1/2 grain is just start.

Or you can get it compounded at double strength, at 20%. 200mg per ml

 

[JesusReagan]

Your hypo. The new range on the TSH scale is to 2 or 2.5, and no longer 5.5. But many doctors don't know it. Even still, TSH is a pretty piss poor test to check out the thyroid...
you need free t3 and free t4 checked.

And often the underlying cause of low thyroid is tied to low adrenals.

I agree. I did more research yesterday after posting, and I saw in several places where the TSH scale has been changed. I think it's odd that the Quest tests still shows the range as being .5 - 5.5. I can see the doc not knowing that, but I'm suprised Quest still has the old scale listed on the test results.

 

[hardasnails1973]

Or you can get it compounded at double strength, at 20%. 200mg per ml

Think the thicker it is more likely it will not be absorped properlly . same goes for T creams. only so much can be packed in for optimal absorption..

 

[JanSz]

Or you can get it compounded at double strength, at 20%. 200mg per ml

There is so many possibilities it is worth talking to them.
Last time I was told about another combination, that is all available ingredients that would fit into 1gram of cream.

DHEA - 100mg
Pregnenolone - 50mg
Testosterone -50mg
Chrysin -50mg

HAN is right, I stopped my Tcream, bad absorption,
that was surprise as I was absorbing Androgel real nice
10grams Androgel---> TT=932

 

[hardasnails1973]

There is so many possibilities it is worth talking to them.
Last time I was told about another combination, that is all available ingredients that would fit into 1gram of cream.

DHEA - 100mg
Pregnenolone - 50mg
Testosterone -50mg
Chrysin -50mg

HAN is right, I stopped my Tcream, bad absorption,
that was surprise as I was absorbing Androgel real nice
10grams Androgel---> TT=932

with preg cream did it alter your e2 levels as well
Plus with e2 of 19 and shbg of 37 could this actually predispose one to estrogen deficeincy?

 

[plymouth city]

Think the thicker it is more likely it will not be absorped properlly . same goes for T creams. only so much can be packed in for optimal absorption..

Not true, one would just need to spread it out on a bigger absorbtion site.

For whatever reasons, Preg seems to work better than T in cream. Lots on non T gel responders have had great success with preg cream.

Preg cream is becomming standard fare like hCG in TRT protocols.

 

[hardasnails1973]

Not true, one would just need to spread it out on a bigger absorbtion site.

For whatever reasons, Preg seems to work better than T in cream. Lots on non T gel responders have had great success with preg cream.

Preg cream is becomming standard fare like hCG in TRT protocols.

Orally dhea is doing crap !! So i think pregenlone cream will help out tremendously..i know the hcg was kicking dhea up nicely....

 

[JesusReagan]

Your hypo. The new range on the TSH scale is to 2 or 2.5, and no longer 5.5. But many doctors don't know it. Even still, TSH is a pretty piss poor test to check out the thyroid...
you need free t3 and free t4 checked.

And often the underlying cause of low thyroid is tied to low adrenals.

Ok, thanks for that info. What is the test for low adrenals? I have blood test results listed under my log "JesusReagan Log" here in this forum.

 

[KSman]

Do creams need to have more lipids or glycerin to carry the hormones into the skin? My W.I.P. cream seems to dry too fast. And my local compounder's 5%T cream (lipoderm) also drys fast. I am temped to add a small amount of DMSO to a small sample and see how that works.

 

[JanSz]

with preg cream did it alter your e2 levels as well
Plus with e2 of 19 and shbg of 37 could this actually predispose one to estrogen deficeincy?

My E2 did not changed since I started using preg cream.
But I did number of changes where I could have had E2 changes and they did not materialize. (Increadse in DualAction pills and addition of TMG). But my estrone and total estrogen changed for better.

 

[hardasnails1973]

My E2 did not changed since I started using preg cream.
But I did number of changes where I could have had E2 changes and they did not materialize. (Increadse in DualAction pills and addition of TMG). But my estrone and total estrogen changed for better.

I am already on TMG plus 500mgs calcium d and low dosages of DIM 75 mgs a day.

do you feel better since being on the creame at all and did your dhea also went up too..

 

[JanSz]

I am already on TMG plus 500mgs calcium d and low dosages of DIM 75 mgs a day.

do you feel better since being on the creame at all and did your dhea also went up too..

No , not really.
Or, hard to tell.
I started pregnenolone cream together with Tcream.
Now I know that I did not absorbed enough the Tcream.
I ended up with low TotalT, my erections started to be rather questionable. Night wood was short lived.
So it was hard to see any difference due to preg cream.
Now, since I started Depo_T shots, my erections are better quality, night wood lasts thruout the night.
Wish I had a (more) cooperative female near by.

 

[plymouth city]

You cannot titrate the dose well at that strength.

Why not? One could just use half the dose and still get 100mg per day and save money long term

 

[smc252]

I don't feel like facing heat for doing oil-based injections subQ. It's tough enough out there already. So the "slow release" may not be such a good thing in this case.

I am familliar with your weekly shots, and they seem to be the best way to go these days.

What I am wondering is if you have ever used daily or EOD suspension shots? For sub-q, I would assume suspension would be the way to go? (I understand not much is known about this, this is why I am asking.)

Thanks Doc!
Steve :cheers:

 

[neoborn]

Haven't read this yet but I'm taking it that "Examing" is supposed to be "Examining" and not some new fangled thing?

 

[smc252]

Just picking your brain, trying to become edu-ma-cated

T suspension is just not the way to go. The half-life is very short, and it rockets E up.

:think:

The ester slowly releases the drug, so that the dose is smaller in a set ammount of time. Where the suspension just dumps all the testosterone right into you immediatley... Is this correct?

If this is the case, what is wrong with undecanoate bi/tri-weekly? Does it spike and fall too often due to the really long half-life?

Also, could low testosterone be CAUSING thyroid/adrenal issues? I have read that thyroid issues can cause low testosterone. What are your experiences with patients, Dr. John?

What about elevated DHEA effecting the testosterone levels... Is there a way to tell how much is converting to testosterone? (mine is nearly 3X the top of the range, yet total/free test is borderlining low)

I really appreciate all your help, you're a smart man and it's great that you are willing to share your knowledge with everyone, even on your own free time.

 

[KSman]

:think:


What about elevated DHEA effecting the testosterone levels... Is there a way to tell how much is converting to testosterone? (mine is nearly 3X the top of the range, yet total/free test is borderline low)

DHEA is a raw material for T production, but the testes need to be working ok and then you also need LH to get T production. DHEA is necessary but not sufficient.

 

[smc252]

DHEA is a raw material for T production, but the testes need to be working ok and then you also need LH to get T production. DHEA is necessary but not sufficient.

I understand that.

What I don't understand is how MUCH dhea can convert. I am assuming the ammount of testosterone derived from DHEA will be very very small. (Under 50ng/dl)

Could the raised DHEA be an effort to maintain homeostasis if testicular testosterone is lowered?

 

[KSman]

I understand that.

What I don't understand is how MUCH dhea can convert. I am assuming the amount of testosterone derived from DHEA will be very very small. (Under 50ng/dl)

Could the raised DHEA be an effort to maintain homeostasis if testicular testosterone is lowered?

I don't think that there is any pathway to convert DHEA to testosterone other than at the testes. I don't know if that addresses what you were thinking.

 

[anatolian]

This a great thread, I will be honest I dont know to much of what is being said but it is forcing me to study and I like that. I am on a gel made by a compound pharmicist, and my test levels are back to normal and so far nothing else has been affected according to test results. (Test was the only problem beforehand...estrogen, progesterone, etc. were all in the normal range)
Oh, that reminds me I did have a slightly low thyroid and was put on 30 mg tablet qua, that is what the bottle says, and so far so good.
Thanks to you guys for taking the time to chime in and spell things out for people like me.