Testogel.

Therapeutic Efforts Pharmaceutical
#1

Hi all.

Ive been on testogel 50mg per day now for 2 weeks. feel abit heavy in my head. not thinking wise just bit heavy…

Within a day my right leg got abit numb and stayed this way more or less with a few of and a few worse moments.

My erections got alooot better with 2nd day. libido was alot higher at first however i think this was mostly due 2 the fact that i liked seeing my dick at normal size haha.

However ive been cutting down the dose and skipping 2 days completely cause of gyno worries. I have chest itch but its not so much the nipples its like entire chest and mostly upper chest or the sides almost in the armpits.
Anyways since i dont have any anti E i desided to go slow. What u think? i have heard it can be gyno but could also by test causing this itch so i am bit confused. And a pair of breast is the last thing i need right now.

When i do get horny its like a bomb hitting u not so much like the gentle feeling sneaking up on u like b4 propecia days. But its good 2 know i can still have good erection with higher t in the blood.

I had subclinical low free T b4 going on testgel so maybe thats why i feel abit heavy and different now. Hopefully it will pass and an anti E can make me feel abit at ease with taking gels so i can continue to improve. hope for the best.

Cheers.

#2

You reacted to it almost identical to me. I have heard that the ithcy chest is just from your hormones changing and its nothing to worry about. When its in the nipple, then youve got E issues.

My libido shot up first few days also, but now when i apply it, i dont get anything at all. In fact most of the time my libido and shrinkage is worse after applying the cream.

Please keep us posted on how you go.

#3

I also said i got a numb leg. what i meant to say is that i had a numb ancle not leg. (swedish just wasent translating good that day) i have come to learn that this is water retention and as such is closely related to E worries, so im not so sure my itchy chest just is due to hormones shifts in the body but we will c. taking chrysin and zink as of today.

Will keep u posted.

#4

Well its been 3-4 weeks now on testogel. I do feel more energetic and an improvement in my mood. As of today im dropping trt for now. My chest has visably grown! and its looking real bad (im a vain guy tho) in a guy without muscles and no fat to have an enlarged breast :confused:

I have no lumps in my nipple but i have lumps in my upper chest (where the milk glands are located) and all the way down on the sides of my chest. With this in regard i think my prolactin is waaaaaay to high. Doc dont seem to think theres even a relation between prolactin and trt… he said it must be an elevation in estrogen or that an elavated prolactin could have something todo with it but that would be in no relationship to the trt.
Strange coinsidence in my book… I seem to have alot of these. Bah incompetent doc :confused:

He told me to get of the testo and wait for 2 weeks to c if anything improves.

He talked about nolva but said he dident want to try that cause it could increase chances of cancer. I thought it was used to treat cancer ffs?

He also said that there is no sence in lowering estrogen with a drug.
I dont get it, lowering dht is perfectly okay and can even be prescribed by a dermatologist here ffs, but lowering a clearly elevated estrogen seems to be totally out of the question.

I am really tired of this entire situation right now but ill feel better soon again, just need to get this gyno out of my head for now.

Any info regarding measures to be taken and how soon etc one can hope to get improvements will be greatly appreciated.

Bottom line for me: testogel worked for libido and (erection zise) somewhat for me but raised some other issues.

If u are not prone to gyno by e2 or prolactin (guess this is due to e2) induced enlarged glands i think u should give this treatment a try if yr labs call for it.

Cheers.

#5

When you went on Testogel your testosterone level would have surged upwards. This in turn would have resulted in a greater conversion of one of testosterones principle metabolites- estradiol. Estradiol being the most potent estrogen in the body.

Your Hypothalamus would have sensed the increased steroid levels in the body and downregulated GnRH, which in turn would have caused the pituitary to downregulate LH and this would have reduced your own natural testosterone production. You might even notice a reduction in the size of your testicles.

Anyway what I have described above is called the HPTA negatve feedback cycle, it would have meant that your testosterone level was no longer as high as it was when you fist took testogel. It would have also meant that your estradiol level was high and your crucial androgen to estrogen ratio was poor- hence the increasing gynecomastia.

If you suddenly stop taking the testogel you end up greatly compounding your problems because what you are doing is removing the supplemented testosterone and your natural and limited production takes some considerable time before it is correctly resored by the hypothalamus. In the meantime you are left with an elevated estradiol level which is able to run amok because it is unopposed by androgens.

Stopping testosterone replacement suddenly without a prescribed course of an aromatase inhibitor or antiestrogen is the best, or number 1 way to quickly develop gynecomastia.

To combat the above problems you are facing you could;

A) Go back on the testogel- take it everyday and have E2 checked with a view to being prescribed a low dose of the aromatase inhibitor arimidex- possibly 0.5 once or twice a week.

B) Up your dose of testogel to 7.5g or possibly to 10g depending on free testosterone levels and have the above aromatase inhibitor prescribed.

C) Given your elevated SHBG level- 40nmol/l on the last blood test I saw. You could look to see if you could come off testogel and restore your own testosterone production and increase your crucial free testosterone by lowering SHBG by having Danazol prescrbed.

D) You might want to consider the use of Arimidex alone to lower your E2 level, this alone might free up enough testosterone and restore your health.

Of note if you are going to stay on testosterone replacement, you might want to consider talking to your endocrinologisat about low dose HCG, something that prevents testicular atrophy.

#6

Hi hypo ive been reading alot of yr previous posts in here. When i rejoined this forum u were however not available to us because of personal matters as i understood it. Its really nice to c that u are back if thats is the case or anyhow to have u comment on the above as i understood u have a great deal knowledge.

As i feared, going of gel is not an alternetive without proper anti E. will using a lesser amount of gel and wean off gel as own production sets in also contribute to more gyno than sticking to 5 g / day? I fear the options im delt as my doc categoricly wont prescribe anti E.

Will Chrysin, fishoil, zink, flaxseed etc have no impact in my situation what so ever even at stronger dosages?

Nice to hear from u even when u bring such sad news :slight_smile:

cheers.

#7

A slow decrease of the dose of testosterone is less likely to cause gynecomastia. Zinc dose act as a natural aromatase inhibitor albeit a very weak on and it may also help if you take 50mgs a day as recommended by Dr Eugene Shippen in his book The Testosterone Syndrome.

It is my belief that a lowering of your SHBG would probably benefit you most.

Failing that, a low dose aromatase inhibitor would be your next best bet, be that on its own or in combination with TRT.

Somehow though I think you might have enough natural testosterone production if only you were prescribed an SHBG lowering med.

How easy it is to rectify your predicament depends to a degree on your geographical location. If for instance you were in the US, I think a change of doctor or a referal to a relevant specialist would ensure a more favorable prescribing policy. If though you were in Europe as your name suggests then it could be more difficult.

The gynecomastia that has developed so far can be combated/reduced quite well with a medication called Andractim, which is a dihydrotestosterone gel that is rubbed into the chest, naturally though it can easily cause hair loss as this is the very hormone that you were blocking with finasteride.

This is one of the very few occasions where I would be inclined to say that prescribing guidelines should go to hell in a hand cart. I would consider purchasing Andractim via the internet given its considerable safety record and short term use- if I were in your boat.

#8

He could also try taking DIM+I3C supplements to try and reduce E2.

Regarding Andactrim – wouldn’t exogeneous DHT cause a negative feedback on the HTPA, since the body would sense increased DHT and thus lower T to compensate?

#9

Good point but by then i would atleast have low e2 and low t instead of just low T and high e2. I guess beeing really fatigued for awile beats having a couple of breasts tho. Been fatigued for along time now i can take a couple more weeks. Still its remarkable how well that testosterone worked for me. I actually forgot what it was like to be horny. Hopefully i can find a safer way of obtaining that feeling again when sorted this out.

#10

Andractim has been proven to be effective in the treatment of Gynecomastia. Glen D Braunsteing reported in his 1993 white paper on gynecomastia that in a controlled study 75% of those on dihydrotestosterone had a reduction in breast size with 25% out of that 75% seeing a complete resolution of the problem (25% saw no improvement). It has subsequently been licenced in some European countries to treat gynecomastia.

DIM+13C have no proven benefit in comparison. Furthermore there is actually very little high standard evidence that supports DIM when it comes to lowering estardiol to any significant degree. It was designed primarily to effect clearance of estradiol from the liver, to ease metabolisation of estradiol so as to reduce the chances of developing cancer- not to reduce estradiol in the blood.

So for me Andractim is what I would consider most relevant.

In terms of its mechanism of action;

Andractim being dihydrotestosterone is recognised by the hypothalamus and there is indeed a a downregulation of GnRH/LH and subsequently testosterone is lowered. There very much is a suppression of the HPTA, the negative feedback does occur.

However, the androgen to estrogen ratio, which is the crucial factor in determining the proliferation or reducing of gynecomastia is positively altered in favour of androgens over estrogens and the result is that the endocrine balance can allow for a reduction in glandular tissue that constitutes gynecomastia.

Because dihydrotestosterone is a non aromatizable steroid that unlike testosterone cannot be converted to an estrogen, the suppression of the HPTA is short lived once the medication has been withdrawn as long as estradiol is not independently high due to disease.

Because testosterone is lowered whilst on dihydrotestosterone, there is less of the raw hormonal ingredient to fuel estradiol, so dihydrotestosterone also helps indirectly to low estogens, this again increases the androgen to estrogen ratio and helps reduce/cause atrophy of glandular tissue.

Another positive is that there isn’t really any adverse rebound effect when dihydrotestosterone is discontinued.

The idea is that gynecomastia is reduced by positively affecting the androgen to estrogen ratio or balance and that it helps a little to reduce estrogens and when the treatment is withdrwn that the effect is permanent as long as disease or continued underlying hormonal problems do not remain.

In this case the gynecomastia appears to have developed on the basis of TRT, if the TRT is not something that is continued, you would expect Andractim to help rectify matters.

There are side effects as with most things.

Hair loss can increase and a short term lack of testosterone can cause fatigue and even back pain.

#11

Do u guys know of any studies done on testosterone supplemented related gyno or gyno in general, that is not an article on body building sites as doc would categoricly dissmiss them as such. Or Just another health site whos name or content isent related to body building (meso, anabolicmind etc) but still adress the importance of anti E in trt or gyno?

I feel this is what i need to convince doc to prescribe arimidex.

Thanks in advance.

#12

Arimidex is great fro preventing gynecomastia, but it is less successful in terms of reducing it once it has already developed than Andractim DHT and like all aromatase inhibitors it does have a slight rebound effect when the medication is removed- albeit not to the same degree as is typically seen in anti estrogen SERM medications such as Tamoxifen.

If you want to push for a prescription of arimidex then you could show your doctor this abstract and get him/her to obtain the full article.

nature.com/ijir/journal/v16/ … 1154a.html

Alternatively you could provide an email address here or via pm and I can send you the full text.

Below is an article that details the usefulness of dihydrotestosterone gel (go to the treatment sub heading).

endotext.org/male/male14/male14.htm

Here is a site that sells Andractim.

allsaintsclinic.org/gynecoma … ents.shtml

I am not saying you should buy it, but I am saying it would have a reasonable chance of reducing or even resolving recently developed gynecomastia. I am also saying that it is a safe medication and I am saying that has been licensed for the treatment of gynecomastia in Belgium and some other European countries. It is made by a major pharmaceutical company (Besins International).

What you choose to do with the above information is your prerogative.

If you reduced/resolved your gynecomastia via Andractim and then prevented its return via prescribed arimidex, I think that would be a reasonable result and the arimidex might help you generally in terms of symptoms if dosed correctly.

The above said I still feel as though your SHBG is the main culprit and the first thing that you would want to lower in order to sort your health out.

#13

I am not too keen on the dht gel as u know i had a very bad reaction to an increased dose of dht in my system when i quit propecia. I was thinking arimidex just to make sure it will not progress anymore and possibly to reduce size too in terms of excess fat. My gyno has not given my pretruding nipples so far and this is what i want to prevent. I just have lumps on the sides of my upperchest and above the nipple. Also arimidex alone could possibly help me get my own T online faster and as u said b4 maybe help me increase my own free T.

Nolva raises shbg as i understand it and that is not what i wont to do right now either.

I feel arimidex is worth a try.

thanks again.

#14

I just wanted to place the options in front of you in a detailed manner. You have considered them logically in accordance with your own priorities which is perfectly sensible.

I hope you can get a sensibly prescribed dose of arimixed that can be correctly monitored via pathology.

If you require the full text for that article then just let me know an email adress and I shall attach it to a mail. If you don’t do that I shall presume that the abstract is sufficent.

Best of luck

#15

So turns out i could be hypocondric after all eh ???

Help me shred some light on this cause i stand abit dumbfounded by these results. I realise DHT is not included here so could be the missing information but it still weird to me.

Labs b4 testogel.

s-prolactin 7.8 (3-13)
s-fsh 3.3 (1.0-12.5)
s-lh 2.1 A (1.2-9.6)
s-östradiol <150 (unsensitive e2 test i guess have to redo this one) also no lab ref.
s-dheas 9.5 B (4.3-12)
s-shbg 40 (20-50)
s-testosterone 12 (10-30
s-testosterone bioactive 5.2 (6.3-16)
tsh 1.0 (0.1-4.8)

Labs after testogel for 3-4 weeks (not even on full doze of 50mg all the time)

This was drawn 3-4 weeks into testogel about 3 hours after applying it.

s-prolactin 5.4 (2-12)
s-fsh 2.4 (1.4-18)
s-lh 1.6 (1.5-9.3
s-östradiol 47 (30-160)
s-dheas (wont get results till later this week)
s-shbg 39 (11-52)
s-testosterone 12 (8.8-32)
s-testosterone bioactive (wont get results till later this week)
p-psa 0.86 (<4)

These tests as seen here (in absence of a few missing pieces) are basicly identical and there is no increase in total T either so where did the supplemented T go straight to dht or was i totally shut down allrdy just leaving me at the same level as b4 gel? . Now it gets interesting as i compare symptoms b4 and after.

Symptoms b4 testogel scale 1-10 obviously 10 beeing the worst.

fatigue: 6 (this is what bathers me the most even if its only at 6)
libido: 8 (This should bather me more but really dont since had for so long it almost becomes normal to feel asexual)
erections: 5
depression: 4
scrotum shrinkage: 5 (almost only when doing sports or moving around, tight sack)
testicle disscomfort: 3
ejaculate volume: 6

Symptoms while on testogel.

fatigue: 5 (dont think i was on long enough to benefit much from this)
libido: 0-1 (1 beeing in the evenings or mornings)
erections: 0-1 (1 beeing in the evenings or mornings)
depression 2 (not a valid marker have had great weather so doing more stuff)
scrotum shrinkage: 2 (only in the mornings or late at night)
testicle disscomfort: 0 (had some the first week but then whent away.
ejaculate volume: 3-5 (seemed to be good sometimes others not so good however the sensation was stronger)

So how can this be ? i know its easy to shout dht but i dunno i am confused. Makes me wonder bout the whole importance of drawing blood and making conclusions from the results. Could it have been a too low E thats been killing my libido? Had to have been even lower b4 gel.

As for my gyno im also confused considering i have high shbg and lowish e2 it really shouldent be happening if indeed its e2. Pls share yr opinions on this, maybe progesterone, remember hearing that could potentially cause gyno? Or is this as my doc suggested all in my head again. I hate when i start to feel like i cant trust my own sensations.

Anyways my doc seem to think i have experienced a very good placebo effect and told me that it usually takes atleast a month to c an improvement and that i should stop reading stuff on the net cause u get what u expect to get… So my genitals are an inch thicker from shear expectancy?? i doubt that very much.

I realize even some of u will have trubbel thinking this many symptoms nearly dissolved after 3 weeks at this point in time 1.5 years of propecia simply by trying trt.

Pls share yr thoughts.

#16

Testogel affects your hormonal levels as soon as it hits the bloodstream, symptoms related to deficiency can improve in hours, your doctor is talking out of his hat.

If you go on the yahoo hypogonadism forum and ask if what I have said is true they will confirm what I have said.

It might take months for the full extent of certain effects- but that is something different.

Anyone can experience the placebo effect, whether that is something you experienced or whether you experienced the effects of the testogel is something that is unknown.

Did you feel better initially from the gel and then lose some of the benefits?

Regarding your bloods, they are a little unusual, but the obvious conservative thing your doctor could do would be to increase your testogel dose. Less than one packet is a very low dose.

I still think your SHBG is too high and that you probably have enough natural production to supply enough free testosterone if you can get SHBG lowered.

But the ball is in your court.

#17

I dont mean to hi-jack this thread, but one thing that happens to me when I apply T cream, is that I feel bloated and penile sensitivety gets worse. Also I get shrinkage in a big way. I wonder if I am converting to E too much (even though blood test tell me otherwise)…like my E is too high for ME? It could also be that im still not converting to DHT like I should be so E is going stupid.

I agree totally that Testosterone can have effects within hours, even within the hour. Unfortunately for me, those effects are negative as far as libido and sexual function go. Of note though, if I feel low on T, my brain fog and tiredess does seem to get a lot better once ive had the T, mainly the brain fog.

Hope this might help in some way, others who are on or tried TRT.

#18

Everything you ahve said has me nodding. There is no doubt whatsoever that many men have a response similar to yours J89.

The cognitive improvement and the reduction of fatigue bu the other additional and unwanted effects.

The negative effects that you and others have mentioned could be down to a number of differing issues and it may even be that there are people reported similar effects that are caused by differing mechanisms.

It could be that E2 becomes elevated on testosterone is your case and that an independently high estradiol level is causing problems, SHBG also has a role to play here. It certainly can be true that although high SHBG is a problem in its own right, low SHBG can also be a problem with swings in the level of free estradiol. Liver function may also be an issue for some. Dr Shippen talks about how poor liver function can cause something that he labels as metabolic hypogonadism. We are probably looking at something very complicated and even multifactoral.

What you can do is get regular extensive pathology with a top andrologist/endocrinologist who specializes in these matters and run through things very carefully with a fine tooth comb, with the idea of identifying what may be causing the problem in your individual case.

#19

This is what makes this so hard, we are all different so we cant go by what the doc seems to think is normal. I dont feel normal unless i take the testogel so how could i possibly be normal without. Like u said the side effects could be unwanted :confused:

Ifs funny how differnet we react, my girl even made a remark about the short length of our sex while on testogel and u complain about numbness.

Hypo u say the ball is in my court- i know.
But can u even theoriz about what could be causing my enlarged breast glands ? could it be my e2 even when its that low, or do i need to test for something else at this point? Also could a lab value of Östradiol <150 mean that its too low to measure (saw a poster saying this in regards to his labs) if so then atleast there have been an increase in my e2.

Im kind of excited about all of this because if not for the chest issues i feel like i could be feeling well again.
I dont know if this is any information to be drawn from this but additional to the enlargement of my breast glands i also have enlarged lymph nodes in my neck. I had that when coming off propecia too.

thanks again.

#20

I think I have already offered an explanation as to what could be happening.

To start with your free testosterone was a lot lower than your total testosterone despite estradiol not being high.

The reason?

Probably the elevated SHBG level.

You then take testogel, at a low dose. At first you gain from the added testosterone of the TRT, then your hypothalamus recognises the additional testosterone and slightly reduces your natural testosterone production.

Your free testosterone could now conceivably be lower than prior to TRT, or your free estrogens could be higher. In other words either your androgen to estrogen ratio could be worse or independently your estogens could now be too high. Remember SHBG is more important even than estradiol when it comes to exerting an estrogenic affect.

Other than that it is possible that your liver might not be effectively metabolising estrogen fast enough leading to a more pronounced estrogenic effect.

Then again you might just have a chest that is excessively sensitive to the actions of estrogens.

They are the main possibilites as I see it, I think the first scenario is the most likely of the three.

I think if you could have your SHBG lowered, I think you might not require TRT and if you did, you still would probably fair better.