With any TRT your HPTA will shutdown, LH and FSH production stops which in turn leads to testicular atrophy, perhaps 24x7 aching. Testes shrink and scrotum pulls up tight. Testes no longer produce pregnenolone. Adrenals thus make less DHEA.
250mg hCG injections SC EOD prevent those problems and support mood.
It is important to avoid testicular disfigurement and reduced or lost fertility.
Some do not absorb transdermal T very well. Some do for a while then stop. Those with thyroid problems are classic not absorbers. For those who do not do well on gels, some higher concentration compounded creams can be better. Injections are the best option if transdermals are not working.
Big pharma transdermals are very expensive. Compounded creams are reasonably priced. Injected testosterone is low cost.
For many, that much agel will not increase T much, but will down regulate or shutdown their HPTA while increasing estrogen, specifically estradiol aka E2. Transdermal T products that are spread over large areas of skin can jack up E2 levels. Result can be feeling worse than before.
In most cases, all forms of TRT will require E2 management. Few doctors will test E2 or know what to do. Arimidex/anastrozole aka adex is used to reduce T-->E aromatization. Typical is 1.0mg/week as an oral drug. Pharmaceutical tablets are expensive. Anastrozole is but one of a class of drugs that are aromatase inhibitors [IAs].
Elevated E2 can kill the benefits of high serum T levels. E2 control is vital for a good outcome. Good target is E2=22pg/ml.
So you need T+AI+hCG
There are no OTCs that will do what is needed to address the above issues.
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