T Nation

T Cream 60mg/Day - Good Dose? How Much Will T Increase?

I was on paroxetine and then fluvoxamine from when I was 22 until I was 24 I think.
I stopped because it wasn’t helping that much with my OCD, it was giving me nausea every time I took it and it was killing my dick.
I didn’t quit cold turkey, but I went from 150mg/day fluvoxamine to maybe 50mg/day, then every other day in just a few months. I had some electric shocks in my brain when I stopped completely, was vomiting a lot but I could take it so I just stopped completely one time. Not sure if this fucked my penis forever. I hope not.

I tested my total testosterone two times.
2016 and it was 306ng/dl.

In 2019, I tested some other stuff. and it was 222ng/dl.
Total Testosterone 222ng/dl - European reference values are now between 165 and 750, stupidity.
FSH 7.1ui/L
LH 8.7ui/L
Prolactin 65.5ng/ml (prolactin was probably high due to having ejaculated due to semen examination needed aswell)

I was denied any help from a urologist and a GP due to my (extremely low) testosterone still being in the new 2018 updated range.

I’m now going to a private clinic to see if they can fucking help me. I’m getting depressed because my penis isn’t working just like before I started SSRI’s.

My question is will TRT actually be able to help me get back to where I was before SSRI’s? I’ve been reading a bit and there’s no consensus yet. I used to have really good erections, really good libido and now libido is gone and my erections are really soft. No morning wood in years aswell. And just recently my reaction time has gone downhill, I’m having brainfog (seems like I’m just a zombie walking around with no cohesive thoughts) and I’ve been feeling sadder.

Maybe on a good day with a good position my dick will be 70%-80% hard of what it was before.

Will I get better?

You might be looking at testicular failure (primary hypogonadism) being that LH and FSH are high and testosterone low. I had the same thing happen to me after tapering off Clonazepam, my brain hurt for months and at times was unable to walk.

If low-T is causing your low libido and erection difficulties, then TRT will improve everything across the board. A lot of docs confuse the reference ranges and those defined as low-T, example the endocrine society here in the US defines low-T below 300, but the ranges go all the way down to 264 ng/dL.

Docs are taught in range is normal, so it’s easy to see why they are confused. So either your docs are ill informed or they just want nothing to do with steroids and will make any excuse to deny treatment.

There are studies showing men have hypogonadal symptoms between 300-400 ng/dL, if you ask me the medical community has some catching up to do.

Can hypogonadism be caused by SSRI usage?
I’m 100% sure the cause for my low libido and erection issues were the SSRI’s.

I just read here that “A 30-year-old male experienced a severe drop in sexual desire, moderate erectile dysfunction, difficulty reaching orgasm with a long refractory time, reduced ejaculate volume, and genital anesthesia within four to five days of starting sertraline. The drug was discontinued after five weeks, but the problems remained unchanged several years later. Sildenafil, supplemental testosterone, and herbal remedies were tried but without success.”. So I’m losing a bit of hope.

Hopefully the SSRI’s caused my testoterone to decrease but didn’t fuck any other receptors because from my understanding I can inject testosterone but I can’t repair any neurotransmitters/receptors.

I’ve tried searching the forum already in regards to TRT after SSRI usage but haven’t seen any positive reports yet.

I’m in Europe and 300 was the range prior to 2018, it was update to 165 in 2018 for some reason. I’m assuming sedentarism and technological society are two reasons that are causing lower testosterone in men.

My urologist told me it might be psychological and to maybe see a psychologist.
And the GP simply told me the values were inside the range and told me to fuck off basically. I wish I new about TRT sooner, my sex life has seen a sharp drop altogether.

Keep in mind a lot of the labs, at least in the US, better standardized their testing standards, which adjusted the ranges as well to match the updated values they were getting. i.e. blood that measured 500 before the standardization might measure 400 now… It’s the same amount of T but being reported differently. That’s why comparing your value to the reference ranges of the same lab is so important.

I’m not saying they haven’t gone down… they more than likely have, but that isn’t 100% of the reason they changed, at least in the US.

Fluvoxamine Plays an Integral Role in the Alteration of Sexual Behavioral Pattern more in Females than Males

It has been suggested that the use of SSRIs can result in persistently altered cerebral gene expression leading to compromised catecholaminergic neurotransmission and neuroendocrine disturbances such as reduced hypothalamic-pituitary-testis axis (HPTA) function, leading to decreased testosterone levels, reduced sperm counts, and reduced semen quality with damaged sperm DNA.

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Can this be fixed with TRT though?

I’m assuming neurotransmitters have nothing to do with testosterone and that increasing it won’t fix the neurotransmitters?

Sexual function is more than just hormones, it’s neurological as well. There have been countless men who have recovered normal sexual function following the use of TRT, but TRT isn’t going to work for everyone.

Your pituitary based off your labs is functioning perfectly fine, it the testes that I think are showing signs of distress. You owe it to yourself to at least find out and it does no good to spend the next 10 years wondering should I try TRT as your sex life is passing you by.

Total Testosterone - 222ng/dl - this is how much I have in my last blood exams.

Went to the doctor today and she prescribed me a testosterone cream.
60mg/day in my forearm.

I wanted injections but I’m not sure she was too keen on them. She mentioned that creams releases testosterone in a more natural way to the body than if it were weekly/monthly injections. I asked her what about biweekly injections but she still said no.

Is this a good dose? She said she wanted to start slow as to not pump the body with a lot of testosterone and that in 3 months we’ll reassess.

Also, is it possible to know how much will my testosterone increase with a cream with 60mg/day?

RE: Estimating levels: Not possible in my opinion. TRT is dependent on too many factors. If it was injectable TRT you can get a ballpark guestimate but creams are absorbed so differently in people there is no way to predict your body’s absorption.

I originally started TRT with creams and went up to 200mg 3 times daily on forearms. also tried the sides of my body and inner thighs and I could not even get my TOTAL T above 300. This was below where I started naturally!!! The cream shut down my natural production and now I was lower than when I started. I switched to pellets and then later to injections, and am now happy. Some people have great luck with creams but I could not absorb them at all.

If it’s really a cream and not a gel you can try applying to your scrotum. Guys typically get better absorbtion there, though I haven’t used a cream myself. Don’t try if it’s a gel, they usually have alcohol which can be uncomfortable…

You’ll just have to try the product and see where you get to. 60mg a day via cream seems a bit low to me, I usually hear of between 100-200mg/day divided into 2 applications.

It is on the low side IMO but you’ll have to see how you do on it. Most people I’ve seen on cream start in the 100mg to 200g/day range.

Cream adds a layer of complexity on estimating what it would do you for you, so I honestly have no idea. Is she willing to increase if that’s what you need? You certainly won’t need 12 weeks to tell if it’s going to get your levels up… cream does that very quickly.

Like mentioned earlier, scrotum application will give higher levels and higher DHT, so some people prefer that. I say it’s worth a shot…

You need to ask your doc what testosterone levels she is targeting for therapy, if she says no higher than 500 ng/dL, you need to find another doc fast.

I remember she telling me that I should be atleast 800ng/dl but I also thought that it’s a big stretch going from low 200 to 800 with just 60mg/day.

I’m going to go to two more doctors as I’d like to get a few different opinions.

I don’t quite agree with her that cream won’t make me infertile. From all the information around exogenous testosterone will stop your natural testosterone production.

What?! If you are sure you heard that correctly, you need someone else. That’s embarrassing.

She can’t have many patients on TRT using cream. If so, and she is telling them that, some are going to find out their fertility decreased. Then the attorneys will be involved.

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I just switched from testogel to cream a while ago. I was in the top 1/3 range of tt and ft on testogel. Thinking I may be sensitive to test, when I switched to cream I talked the provider in to 60mg a day.

I applied on thighs. I felt kinda crappy and libido/erections was very low. Upped dose to 100mg per day after 7 weeks or so and things improved a bit. Tested after a few weeks of that dose and I’m bottom 1/3 of range in tt and ft. Dht went down too.

I’m a Propecia side effects guy, so I’m scared to go with scrotal application because I read a couple times of guys way over the dht range crashing. I figure that’d probably happen to me.

Switched to 100mg of test cyp per week divided up every 3.5 days. Took my first shot this morning.

Long story short, I think 100mg of cream is probably the minimum dose (nonscrotal) to feel anything. And that may be too low, too.

100mg daily of cream equals to like 100mg cypionate weekly so yes.
The doses for the cream are usually around 150-200mg daily, I know people who need 300 because everyone absorbs it at different rate. The good thing about the cream is it is fast and you achieve stable levels within one week.

Get started on TRT and you will find out if it helps or not.

Short answer yes it will help. It’s T. The body needs it to stay healthy from top to bottom and inside To out.

If you need T take it and then realize the benefits.

Don’t over think it.

T is a hormone men need to stay alive. Without T we will die. Low t means close to death.

No 60mg a day is shit. At the least take 1 click am and 1 pm. See where levels are and have a doc that’s willing to increase.

Don’t go reading all over the Internet “cons of TRT” because it’s all bullshit. You’ll fall into a real trap and be too scared to increase dose or blame estrogen for all your symptoms.

It takes time after you start. Make sure the pharmacy is MedQuest or empower:hollandaile if you don’t have a choice.

Otherwise you might not do well on the cream. Because it’s hard to formulate. One mistake and you get an inconsistent dose.

If you don’t have a good pharmacy (MedQuest is literally the only one that third party tests it’s cream ensuring it’s consistently potent) I would use injections on a daily or eod basis.

This is scrotal cream right?

Enjoy. Many men reverse diabetes and their depression decreases substantially when they start trt. Many have these issues because they had low t.

BLOOD WORK FROM TODAY
Total Testosterone 500.8 ng/dl (72 - 853)
Free Testosterone 23.21 pg/ml (4.81-22.42)
Cortisol 14.9 ug/dl (5-25)
Folic Acid 2.10 ng/ml (>5.38)
Vitamin B12 415 (246-911)
Estradiol 28.8 (0 - 40)
SHBG 18 (10-57)
Protein C <0.05 (<0.30)
TSH 1.98 (0.5-4.7)
T3 total 1.61 (0.60-1.81)
T3 free 4.0 (2.3-4.2)
T4 free 1.32 (0.70-1.58)

OLD BLOOD WORK
2016 - Total testosterone - 306ng/dl.
2019 - Total Testosterone 222ng/dl - European reference values are now between 165 and 750, stupidity.
FSH 7.1ui/L
LH 8.7ui/L
Prolactin 65.5ng/ml (prolactin was probably high due to having ejaculated due to semen examination needed aswell)

I have no fucking idea what’s going on. I never took any testosterone and I’m feeling worse in terms of ED and brainfog/tiredness/fatigue than I ever did in 2016 and 2019 however my testosterone is higher for some reason?

How the fuck can I go from 200 to 500 in 1 year with no exercise, eating shitty food and not taking testosterone? Seems fucking fishy.

I’d do another round of tests. At least the basic total t free T e2 ones.

What’s the normal range on your prolactin and have you had tests where it was normal before?

Haven’t done any more prolactin tests.

This all seems weird, my testosterone was never this high and I’m feeling way worse than when it was 200 or 300. Something’s not quite right.

Maybe this is PSSD due to the SSRI’s and there’s no cure for my ED and I’m just fucked for life. Which I seriously hope not.