Compounded cream BID doses question

[damon1]

Sorry to be posting a lot of questions but I'm pretty new to hrt and so far my doctor isn't very helpful with questions concerning it. I am going to see a new doc but was hoping some of you with experience could answer a question I have. I just started using a compounded cream that I got from CollegePharmacy, it's 10% and my dose is 1gm. I saw where Dr. Crisler and others recommend applying it BID instead of once in the am. Should I just split the dose and do .5gm in the am and another .5gm in the evening? Also, when is the proper time to apply the second dose? Afternoon or evening? I really appreciate the advice and am learning a lot from this great site.

[TheTrain87]

How long have you been on the dose of 1 gram at 10%? How do you feel taking it once a day? I can't speak for Dr. J., but what I remember him saying is their are advantages to taking it BID. Some men don't feel much of a difference taking it once a day vs. twice a day, so you would have to make that decision. In my experience taking it once a day a would be way more convenient; twice a day dosing is very inconvenient for me and I sometimes have to plan my life around it.

[damon1]

I just switched from Testim to the compounded cream yesterday. While on the Testim, I was applying 2 tubes in the am but I felt that the effects wore off later in the day. It did raise my tt levels from 270 to 518, so it was working but I switched to the compounded formula because of cost. Too early to tell on the cream but like I said, I saw where Dr. Crisler did say BID dosing was better but didn't go into too much detail on it.

[JanSz]

I just switched from Testim to the compounded cream yesterday. While on the Testim, I was applying 2 tubes in the am but I felt that the effects wore off later in the day. It did raise my tt levels from 270 to 518, so it was working but I switched to the compounded formula because of cost. Too early to tell on the cream but like I said, I saw where Dr. Crisler did say BID dosing was better but didn't go into too much detail on it.

What was your DHT while on 2 tubes of Testim?????

518 is definitely better than 270.

518 is usually nothing to write home about,
specially when you used two tubes.

What is your SHBG????

Testim is 1%, it have easy way to get in because it uses large skin area.

If your compounded cream have a higher density, I do not foresee much chances for success.

Because you have got only TT=518 while on 2 tubes of testim
you
may have thyroid problems.


..

[pmgamer18]

Many yrs. ago I was on CP's compounded cream 10% I think is was mixed with DHEA and I did 150 mgs per day.

I put it on my forearms in the morning and it lasted all day. I read about doing it 2x's per day so at 6 pm I tried doing this half in the morning and half at 6 pm it kept me up all night long. Your normal Testosterone levels not on TRT are highest in the morning falling low by bed time. So if you try this and you can't sleep you will know why.

Sorry to be posting a lot of questions but I'm pretty new to hrt and so far my doctor isn't very helpful with questions concerning it. I am going to see a new doc but was hoping some of you with experience could answer a question I have. I just started using a compounded cream that I got from CollegePharmacy, it's 10% and my dose is 1gm. I saw where Dr. Crisler and others recommend applying it BID instead of once in the am. Should I just split the dose and do .5gm in the am and another .5gm in the evening? Also, when is the proper time to apply the second dose? Afternoon or evening? I really appreciate the advice and am learning a lot from this great site.

[damon1]

What was your DHT while on 2 tubes of Testim?????

518 is definitely better than 270.

518 is usually nothing to write home about,
specially when you used two tubes.

What is your SHBG????

Testim is 1%, it have easy way to get in because it uses large skin area.

If your compounded cream have a higher density, I do not foresee much chances for success.

Because you have got only TT=518 while on 2 tubes of testim
you
may have thyroid problems.


..
I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.
You could be right about the thyroid problems, I'm noticing that the compounded cream doesn't look like it's absorbing too well. Seems like when I rub it in on my forearms, it kinda clumps up especially if i rub it hard. Going to try aloe vera as someone suggested in another post to see if that helps. I have an appt. with a new doctor in 2 weeks so I'm going to talk with him about going to injections.

[canthavetoomanytoys]

I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.
How long after applying the gel did you have the blood drawn?

Make sure you ask the new Doctor their thoughts on SHBG, managing E2, the use of hCG, and the importance of high range bioavailable testosterone. These questions should help determine your longevity with the chosen doctor.

It is probably not a bad idea to do some thyroid tests at least fT3, fT4, and antibodies.

[damon1]

How long after applying the gel did you have the blood drawn?

Make sure you ask the new Doctor their thoughts on SHBG, managing E2, the use of hCG, and the importance of high range bioavailable testosterone. These questions should help determine your longevity with the chosen doctor.

It is probably not a bad idea to do some thyroid tests at least fT3, fT4, and antibodies.

I had the test done before applying the Testim. I have given up on the compounded cream, I can tell I'm not absorbing it so I'm back to using the Testim. I'm going to try and see if there is a compounding pharmacy that can make a t-gel that resembles testim since I do absorb it well, if not I will have to go to injections. I have a doctors appt. in 2 weeks with a new doc and will get bloodwork done and discuss injections.

[chilln]

I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.


Hello damon1, good to see you posting some labs - we need more of those here. Could you please post all your most recent labs, in summary format (not as images please) ?

I know this sounds like a pain but you've been asking asking a very narrow set of questions all trying to relate gel / cream application technique, to your symptoms, in an attempt to get "tuned" (ie: get your health to the point when your health symptoms are eventually excellent).

I'm sorry to be the bearer of less-than-optimal news, but you and your medical professional adviser are going to take years to get tuned with that line of questioning.

To reduce that timeframe from years to months, you and your medical professional adviser are going to need to monitor, and make a reasonable effort to understand, how a set of several of your main hormones are interacting to cause your symptoms.

###

I'll try and re-phrase the above, by answering your latest question about once daily versus twice daily application times. Here goes:

###

Whether you need to split your T dose is dependent on how quickly you metabolize T (testosterone).

Your rate of T metabolism is critically dependent on insulin sensitivity, cortisol, thyroid hormones, estradiol, GH and of course SHBG.

Your rate of T metabolism is less critically dependent on many other hormones too, but the ones listed above are the main players.

All these hormones, and SHBG, are critically dependent on T. That's life. They all feedback on each other very strongly.

The feedback loops between these most critical hormones are not described anywhere in one place, or even in a limited few places, except perhaps here. Even on this forum they are only discussed as interactive discussions during analysis of a members labs and symptoms and therapeutic trials (dosage-response trials)

All these hormones, and SHBG, are all at least equally as critical as testosterone in terms of overall health.

Since your T has taken a dive, it's unlikely that most of these hormones, are optimum in your body.

If you're experiencing less-than-optimal performance from once-daily dosing of T, then it's unlikely that a switch to twice daily dosing of T will restore the optimum balance of any of these other hormones which may be degrading the performance of your T.

###

The following is not an answer to your question, but a suggestion:

By not monitoring all these hormones, at least initially, and by attempting to manage only testosterone levels, the most likely outcome in your case is that your testosterone supplementation regime will not yield the health improvements you expect, eg; excellent erectile performance, excellent damage tolerance -

By "monitoring all these hormones" I'm referring to:
a) semi-regular acquisition of labs for all of the above hormones
b) regular symptoms analysis
c) regular analysis of all of your previous therapeutic trials / dosage-response trials

By monitoring all these hormones, at least initially, and by attempting to manage the levels of all of these hormones via testosterone supplementation, and if necesssary via supplementation with other hormone modulating substances, the most likely outcome in your case will be that you will take only months to get tuned for optimum health, and not years.

###

I accept that you probably didn't sign on to having to monitor all these hormones, and that having to monitor all these hormones may seem a tall order, and that having to learn how these hormones all feedback on each other is a huge order, but that's the harsh cruelty of hormone modulation therapy.

Only very few medical professional advisers spell this out up front. The vast majority simply respond to a patient's request to boost testosterone, and once you're hooked, then they fall apart when your tell them your erection isn't rock hard for at least 30 minutes every night during sex, or your calves hurt, or your joints are sore, or you can't sleep at least 7 straight hours a night, or you're still getting brain fade, or you're starting to experience anxiety, etc...etc...etc...

###

One way out of this dilemma is to switch to using the services of a medical professional adviser who is one of the small group of medical professional advisers who understand how to monitor and modulate the whole set of critical hormones. Eg: Dr Crisler, Dr Mark L Gordon, Dr Jeffrey Dach, Dr. Eugene Shippen, and a few others.

This is the fastest possible route to getting tuned, ie: almost no mistakes along the way. These core medical professional advisers don't accept insurance, and each visit is much more expensive that a visit to your local doc, and usually includes a lot of travel.

Most members elect a partial approach whereby they team up with a local, but more expensive medical professional adviser than their local doc, and they learn the info that their medical professional adviser doesn't understand, and together they get tuned faster, but not via the fastest possible route.

Ie: they make several mistakes along the way, and then recover and get back on the right track.

.

[damon1]

I agree with what you are saying and I am trying to find a doctor who is educated on hrt. My doctor sent me to a urologist who does hrt but when I saw him, he was horrible and I could tell he didn't have a clue. He just wanted to prescribe t-gel and come back in 6 months to see how I was doing. I am seeing another doctor in 2 weeks to have bloodwork done and if he doesn't work out, I will probably go to Charlotte, NC and see an anti-aging doctor. I found two places in Charlotte(Signature Wellness and Carolina Healthspan Inst.)I live in Cola., SC and have yet to find a hrt specialist. There is no way I can afford to fly out of state and see someone like Dr. Crisler as much as I would like to. Until I can find a good doctor, the only thing I can do now is try to learn from info posted by others on here and do the best I can on my own.

[JanSz]

I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.
You could be right about the thyroid problems, I'm noticing that the compounded cream doesn't look like it's absorbing too well. Seems like when I rub it in on my forearms, it kinda clumps up especially if i rub it hard. Going to try aloe vera as someone suggested in another post to see if that helps. I have an appt. with a new doctor in 2 weeks so I'm going to talk with him about going to injections.

Do not waste time trying aloe vera or anything else.
The only thing that transdermal is good for is DHT.
If your DHT is low, you are stuck with transdermal.
Otherwise, save you self grief, use T-shots
but
save your self another grief
use T-shots frequently
very small dose, very frequent shots

Do not look too much at total test
go by BAT

BAT~575
again, do not waste time, get to BAT~575 within one month
do not use 2 years screwing around, save time for more important items.
Plenty work, you will not run out of job, do not worry.

BAT only from Quest

If no Quest, use FreeT from chart

//

[may19th2001]

It could very well be adequte it depends on how long after the gel was applied you tested, you want to evaluate various factors.
Perhaps when it was applied an hour later they could have been over the refrence range but 2-4 hours you would think they are more stable?
500's may feel ok to some guys however I know some of us may feel side effects if it is at this level, if he feels good etc I would not worry about it.


I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.
You could be right about the thyroid problems, I'm noticing that the compounded cream doesn't look like it's absorbing too well. Seems like when I rub it in on my forearms, it kinda clumps up especially if i rub it hard. Going to try aloe vera as someone suggested in another post to see if that helps. I have an appt. with a new doctor in 2 weeks so I'm going to talk with him about going to injections.

[canthavetoomanytoys]

I had the test done before applying the Testim. I have given up on the compounded cream, I can tell I'm not absorbing it so I'm back to using the Testim. I'm going to try and see if there is a compounding pharmacy that can make a t-gel that resembles testim since I do absorb it well, if not I will have to go to injections. I have a doctors appt. in 2 weeks with a new doc and will get bloodwork done and discuss injections.

Like May replied, a level of 500 may be high enough at 24 hours. Dr Crisler likes to test at
2 hours but he looks at BAT and your responce. 500 may provide a good BAT. You need a experienced doctor to work this through.

[Bulldog]

Originally Posted by damon1
I thought that was good tt level(518 on a range of 280-800) and also my level was actually 176 previously. It was 270 originally but dropped to 176 after using 1 tube of testim for 2 weeks. Doc upped the dose to 2 tubes and rechecked three weeks later tt was 518.
You could be right about the thyroid problems, I'm noticing that the compounded cream doesn't look like it's absorbing too well. Seems like when I rub it in on my forearms, it kinda clumps up especially if i rub it hard. Going to try aloe vera as someone suggested in another post to see if that helps. I have an appt. with a new doctor in 2 weeks so I'm going to talk with him about going to injections.

It sounds like you are spinning your wheels with the gels because that is exactly how the gels were working for me. I would suggest switching to Test Cyp injections and be done with it. I messed with gels for quite a while and now I look back at that as nothing but wasted time.


If your DHT is low, you are stuck with transdermal.

Not necessarily.



use T-shots frequently
very small dose, very frequent shots

Frequent shots aren't necessary unless weekly shots do not produce the desired results. Start with weekly shots and adjust if necessary but only if necessary.

[JanSz]

Like May replied, a level of 500 may be high enough at 24 hours. Dr Crisler likes to test at
2 hours but he looks at BAT and your responce. 500 may provide a good BAT. You need a experienced doctor to work this through.

I cant really imagine the SHBG levels for which TT=500 would be enough.

People who have all hormones and everything else perfectly and naturally balanced may do well on TT=500

Once one is deficient and must supply external testosterone,
it is a different ball game.

Best I could came up with is a goal of BAT=575

At my SHBG levels, SHBG(18-20)
that meant TT~1100
that was the same, when I was on Androgel and now on T-shots.

And when I was on Androgel I was using 10grams, and measuring 24hrs after application.
I newer measured 2hrs after application, but I imagine that it must have been higher.

Personally I do not want to measure 2 hrs after application
because
if I do, I must check it also at 24hrs.

If one is fast metabolizer he may be just right at 2hrs and way down at 24hrs.

I just side tracked all this by testing at 24hr.

There are some extreme fast metabolizers, they need to apply cream 2x/day

I just wish that Nebido arrived (at good price).

We would have 10-20 days intervals between injections, acceptable to more people.
..

[may19th2001]

It depends on the person also Bioavavailable and Free T should be checked also to try to get a more clear picture to see where them tests fall at as well.
I would give it a little time really.



I cant really imagine the SHBG levels for which TT=500 would be enough.

People who have all hormones and everything else perfectly and naturally balanced may do well on TT=500

Once one is deficient and must supply external testosterone,
it is a different ball game.

Best I could came up with is a goal of BAT=575

At my SHBG levels, SHBG(18-20)
that meant TT~1100
that was the same, when I was on Androgel and now on T-shots.

And when I was on Androgel I was using 10grams, and measuring 24hrs after application.
I newer measured 2hrs after application, but I imagine that it must have been higher.

Personally I do not want to measure 2 hrs after application
because
if I do, I must check it also at 24hrs.

If one is fast metabolizer he may be just right at 2hrs and way down at 24hrs.

I just side tracked all this by testing at 24hr.

There are some extreme fast metabolizers, they need to apply cream 2x/day

I just wish that Nebido arrived (at good price).

We would have 10-20 days intervals between injections, acceptable to more people.
..

[chilln]

I am seeing another doctor in 2 weeks to have bloodwork done and if he doesn't work out, I will probably go to Charlotte, NC and see an anti-aging doctor. I found two places in Charlotte(Signature Wellness and Carolina Healthspan Inst.)I live in Cola., SC and have yet to find a hrt specialist.


I'll wait until you see one of these medical professional advisers and post some results.

.