virilisation pictures

[Axl]

Axl, I have one more idea about your DHEA being high and you not virilising. Your adrenal glands are trying to make up for inadequate testosterone levels. How is your cortisol levels, on another thread, it was pointed out to me that the adrenals step up output in the environment of low testosterone. I am not talking about what is considered low on a reference range, I mean what is too low for your body. Some men for example, pmgamer18 need testosterone levels above 1000ng/dl or they do badly. It would be interesting to obtain bloodwork from your, cousins, uncles, brothers and father. I think that would be more relevant to what your levels need to be.

What made me suspect something was very wrong with me, was my now 25 year old kid brother. He is not hypogonadal. Anyone who puts on lean muscle as he does and has sex as much as he does is not hypogonadal. I can say with total certainty that he does not do AAS either. A credible reference range for me would be his total T, free T, etc. I highly doubt that his total T would be under 400 like mine.

Hi Love_en,
Good point: I had high cortisol (if I remember it right..I only had it checked once). They checked my levels bacause I always had painful joints (especially wrists and knees). Cortisol was elevated. But hey: I had the blood of an 80-yr old men at that time: of course I was in pain... Pain releases cortisol, doesn't it?
About that DHEA and DHT: the strange thing is that they are elevated but that there is no virilisation. DHT is ten times stronger than T, so that is the one to look for if you want virilisation. That's also the reason why my doc tests androstenedione gluceronide: it's a marker for androgens at cell level. On the other hand my SHBG levels are always very low: this how my body compensates for the low total T and how it tries to maintain a reasonable free T.

 

[love_en]

I now wonder the same thing your endo does about a lack of androgen receptors. I am on a lower dose of T and I do not need to counteract E2. Also, things changed for the better very quickly in my case.

Before going on TRT, my cortisol levels were at the top of the scale. I was experiencing pain in my bones and muscles due to the lack of T. 2 weeks after starting, the pain was gone.

If your doctor is willing, I would try a higher dose. Because I doubt that it would put your T levels above what is healthy. Some people are androgen insensitive or they excrete T before it is utilised by the body. That is the difference between an American doctor and a European doctor. In Europe, doctors are free to do what is best for the patient. Here, they must do what looks good to the government.

 

[Axl]

Update on my HRT: T+Adex+HCG

Hi Guys,

Here is an update on my latest changes in my HRT. I have done 250 mgs of T enanthate every 10 days and 0,25mg of Adex every 3 days. It gradually got my T levels up to 413 ng/dl (which is low given the high dose I inject, at the same time the 413 ng/dl are the highest T levels I have ever had!!). My E2 is nicely in check, my LH was extemely low (that's also normal given the injected dose).

I asked my doc to add HCG, which he agreed to (I wrote quite an exensive e-mail with all the pro's and the con's and I added, of course, SWALE's HCG-protocol...THANKS SWALE!!!).

At the moment, my T is not high enough to start virilisation and I hope that adding HCG might give my T-levels an extra push upwards. I am not a fan of injecting more than 250 mg of T every 10 days. So I started 250IU of Pregnyl two days and one day prior to my T-shot. This is still combined with 0,25 mg Adex every 3 days.

Psychologically I feel very good. My lack of energy is gone. I am not saying that I am extremely energetic, but at least I have a normal energy level now. I'm not on an rollercoaster ride anymore by injecting every 10 days.

On the physical side: no changes....today a computertechnician that first visited our office called me "madam" when he asked if he could borrow a stapler.... He quicly realised he had mistaken himself, but MAN....I really really hate these embarrasing moments!!!! Of course all my collegues were laughing..... It ain't fun being hypogonadal all your life....

Anyway: does anybody have other ideas what I can do, besides waiting for something to happen?? I have asked for a second Insuline Tolerance Test to see if my GH was still low. If it still is, I might want to consider a struggle with my PCP for adding GH...good idea or bad idea??

 

[cpeil2]

Hi Guys,

Here is an update on my latest changes in my HRT. I have done 250 mgs of T enanthate every 10 days and 0,25mg of Adex every 3 days. It gradually got my T levels up to 413 ng/dl (which is low given the high dose I inject, at the same time the 413 ng/dl are the highest T levels I have ever had!!). My E2 is nicely in check, my LH was extemely low (that's also normal given the injected dose).

I asked my doc to add HCG, which he agreed to (I wrote quite an exensive e-mail with all the pro's and the con's and I added, of course, SWALE's HCG-protocol...THANKS SWALE!!!).

At the moment, my T is not high enough to start virilisation and I hope that adding HCG might give my T-levels an extra push upwards. I am not a fan of injecting more than 250 mg of T every 10 days. So I started 250IU of Pregnyl two days and one day prior to my T-shot. This is still combined with 0,25 mg Adex every 3 days.

Psychologically I feel very good. My lack of energy is gone. I am not saying that I am extremely energetic, but at least I have a normal energy level now. I'm not on an rollercoaster ride anymore by injecting every 10 days.

On the physical side: no changes....today a computertechnician that first visited our office called me "madam" when he asked if he could borrow a stapler.... He quicly realised he had mistaken himself, but MAN....I really really hate these embarrasing moments!!!! Of course all my collegues were laughing..... It ain't fun being hypogonadal all your life....

Anyway: does anybody have other ideas what I can do, besides waiting for something to happen?? I have asked for a second Insuline Tolerance Test to see if my GH was still low. If it still is, I might want to consider a struggle with my PCP for adding GH...good idea or bad idea??

Does GH have a virilizing effect? Never have read that it does.

Doesn't the virilization that you are looking for come more from DHT than testosterone? Occasionally, I have read here of people using IM and a transdermal at the same time. Transdermals typically trigger more of a rise in DHT than the IM route does. Combining the two could give you more of the result you're looking for. There's also transdermal DHT, but the jury still seems to be out on it's safety. Or maybe you just need to give it time. Difficult, I know.

 

[Axl]

Does GH have a virilizing effect? Never have read that it does.

Doesn't the virilization that you are looking for come more from DHT than testosterone? Occasionally, I have read here of people using IM and a transdermal at the same time. Transdermals typically trigger more of a rise in DHT than the IM route does. Combining the two could give you more of the result you're looking for. There's also transdermal DHT, but the jury still seems to be out on it's safety. Or maybe you just need to give it time. Difficult, I know.

You are absolutely right on the DHT.
http://www.aruplab.com/guides/clt/tests/clt_al58.jsp
Dihydrotestosterone (DHT) is the most potent androgen affecting hair growth and androstanediol glucuronide levels reflect the target tissue formation of DHT. Levels similar to that of pubertal males, as well as those between that of normal females and males, will produce hirsutism. Very high levels will result in virilization. The diagnosis of hirsutism depends upon a thorough history and physical examination. Useful laboratory tests include: luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, dehydroepiandrosterone sulfate (DHEA-S), and androstanediol glucuronide (a metabolite of dihydrotestosterone).
Ref Range (male): Adult Male: 3.4-22.0 ng/mL

Since DHT is difficult to measure, it is good practise to measure androstanediol glucuronide (a metabolite of dihydrotestosterone). My lastest test was at 22,4 nm/ml. On top of range... Maybe I should push this a bit futher?? But if you go too far, you will loose your hair...forever... difficult choice huh?

 

[pmgamer18]

Hi Guys,

Here is an update on my latest changes in my HRT. I have done 250 mgs of T enanthate every 10 days and 0,25mg of Adex every 3 days. It gradually got my T levels up to 413 ng/dl (which is low given the high dose I inject, at the same time the 413 ng/dl are the highest T levels I have ever had!!). My E2 is nicely in check, my LH was extemely low (that's also normal given the injected dose).

I asked my doc to add HCG, which he agreed to (I wrote quite an exensive e-mail with all the pro's and the con's and I added, of course, SWALE's HCG-protocol...THANKS SWALE!!!).

At the moment, my T is not high enough to start virilisation and I hope that adding HCG might give my T-levels an extra push upwards. I am not a fan of injecting more than 250 mg of T every 10 days. So I started 250IU of Pregnyl two days and one day prior to my T-shot. This is still combined with 0,25 mg Adex every 3 days.

Psychologically I feel very good. My lack of energy is gone. I am not saying that I am extremely energetic, but at least I have a normal energy level now. I'm not on an rollercoaster ride anymore by injecting every 10 days.

On the physical side: no changes....today a computertechnician that first visited our office called me "madam" when he asked if he could borrow a stapler.... He quicly realised he had mistaken himself, but MAN....I really really hate these embarrasing moments!!!! Of course all my collegues were laughing..... It ain't fun being hypogonadal all your life....

Anyway: does anybody have other ideas what I can do, besides waiting for something to happen?? I have asked for a second Insuline Tolerance Test to see if my GH was still low. If it still is, I might want to consider a struggle with my PCP for adding GH...good idea or bad idea??

Axl good news I started feeling the shots of HCG started at 500 IU's 3 times a week. Got my blood tested after the 15th shot and my Total T levels doubled I went from 650 to 1128 cut back on HCG to 250 IU's the 5th and 6th days after my shot and my Total only came down to 900. E2 has been a problem until I started doing 100 IU's the last 5 days each after my T shot. So hang in there and give it some time. I did feel a feeling of well being on the very first shot. It felt like a ton was lifted off my shoulders.

 

[Axl]

Axl good news I started feeling the shots of HCG started at 500 IU's 3 times a week. Got my blood tested after the 15th shot and my Total T levels doubled I went from 650 to 1128 cut back on HCG to 250 IU's the 5th and 6th days after my shot and my Total only came down to 900. E2 has been a problem until I started doing 100 IU's the last 5 days each after my T shot. So hang in there and give it some time. I did feel a feeling of well being on the very first shot. It felt like a ton was lifted off my shoulders.

hi Phil,
I'm very pleased to see things are finally working out for you. After 21 yrs of testing and misery there is finally a good treatment for you. I only hope I don(t have to wait that long
Good luck to you and keep posting: I have always appreciated the way you are trying to help other people here.

 

[Axl]

GH question

Hi Guys,

Here is an update on my latest changes in my HRT. I have done 250 mgs of T enanthate every 10 days and 0,25mg of Adex every 3 days. It gradually got my T levels up to 413 ng/dl (which is low given the high dose I inject, at the same time the 413 ng/dl are the highest T levels I have ever had!!). My E2 is nicely in check, my LH was extemely low (that's also normal given the injected dose).

I asked my doc to add HCG, which he agreed to (I wrote quite an exensive e-mail with all the pro's and the con's and I added, of course, SWALE's HCG-protocol...THANKS SWALE!!!).

At the moment, my T is not high enough to start virilisation and I hope that adding HCG might give my T-levels an extra push upwards. I am not a fan of injecting more than 250 mg of T every 10 days. So I started 250IU of Pregnyl two days and one day prior to my T-shot. This is still combined with 0,25 mg Adex every 3 days.

Psychologically I feel very good. My lack of energy is gone. I am not saying that I am extremely energetic, but at least I have a normal energy level now. I'm not on an rollercoaster ride anymore by injecting every 10 days.

On the physical side: no changes....today a computertechnician that first visited our office called me "madam" when he asked if he could borrow a stapler.... He quicly realised he had mistaken himself, but MAN....I really really hate these embarrasing moments!!!! Of course all my collegues were laughing..... It ain't fun being hypogonadal all your life....

Anyway: does anybody have other ideas what I can do, besides waiting for something to happen?? I have asked for a second Insuline Tolerance Test to see if my GH was still low. If it still is, I might want to consider a struggle with my PCP for adding GH...good idea or bad idea??

I would like to "BUMP" my question regarding GH. I am partially GH deficient: my ITT-test demonstrated I had a level between 10 mE/l and 20 mE/l. A normal person should score around 30 mE/l. However, the cut off point for being eligible as "completely GH-deficient" is below 10mE/l.... Would adding GH to injection scheme help me to get some virilisation???
Where are the GH experts?? I'm new on this topic.... Please share your experiences: they are much appreciated!!!

 

[HeadDoc]

I would like to "BUMP" my question regarding GH. I am partially GH deficient: my ITT-test demonstrated I had a level between 10 mE/l and 20 mE/l. A normal person should score around 30 mE/l. However, the cut off point for being eligible as "completely GH-deficient" is below 10mE/l.... Would adding GH to injection scheme help me to get some virilisation???
Where are the GH experts?? I'm new on this topic.... Please share your experiences: they are much appreciated!!!

Axl, sorry you needed to prod me on this thread. I don't understand the values for gh you've posted. IGF-1 levels are usually taken to indicated the need for gh replacement. Check out Ron Rothenberg's articles somewhere around here by sticky for the specifics. Taking gh will provoke an estimate 10% bump in testosterone. However, gh also rejuvinates the glands long term. So just as you may be getting some help by keeping the adrenals under good repair, the gh may contribute long term--minimum six months with IGF-1 level around 300. Have you consulted with Dr. Thierry H. in Belgium? Go over to A4M and take a look at some of his references. He's an international expert in your own back yard.

 

[1cc]

Axl,

Thierry Hertoghe is one of the best at HRT, and like Headdoc said, he is in Belgium, your back yard.

 

[1cc]

Taking gh will provoke an estimate 10% bump in testosterone.

Do you have any references for this Headdoc? I would like to read more about it. Thanks.

 

[HeadDoc]

Do you have any references for this Headdoc? I would like to read more about it. Thanks.

Wish I did. It came up in a few lectures I attended. Rothenberg was one of them. The relationship is reciprocal meaning it goes either way--again I don't have a reference. I also thought that the post recommending the combined use of exo test and hcg was innovative for the problem under discussion.

 

[Axl]

Thanks for the tip Headdoc! I have looked into it. Here is an interesting summary doc from dr. Rothenberg. It is a great read!
But I don't agree with his HCG protocol: he overshoots the HCG, IMHO.

www.ehealthspan.com/download/TestosteroneA4M.doc

 

[Axl]

Axl,

Thierry Hertoghe is one of the best at HRT, and like Headdoc said, he is in Belgium, your back yard.

I know...but like all good docs: he has a lot of patients that want to see him...he almost impossible to reach. That's frustrating as he practically lives in my backyard.

By the way: I have also read his books.... There quite good. I can really recommend them.

 

[1cc]

I know...but like all good docs: he has a lot of patients that want to see him...he almost impossible to reach. That's frustrating as he practically lives in my backyard.

Perhaps he can recommend some other doctors in Belgium that he has trained, or that follow the same protocols he does.

 

[Axl]

Perhaps he can recommend some other doctors in Belgium that he has trained, or that follow the same protocols he does.

Good suggestion!

 

[marianco]

DHT (dihydrotestosterone) is the primary hormone for male characteristics, not Testosterone. DHT is created from Testosterone by the Reductase enzyme. A problem occurs if this conversion is blocked. Then less DHT is made. Reductase inhibitors (which block DHT creation) include Finesteride, Progesterone, and some topical hairloss remedies.

Another problem occurs if a person is testosterone resistant. This means their testosterone receptors (which also attach DHT which has about 5 times higher affinity for the testosterone receptors than testosterone itself) cannot bind as easily to DHT. Without DHT, a person then has feminine features. For suce a person, perhaps getting higher levels of DHT is the goal of treatment.

Higher levels of DHT may kill your hair follicles causing permanent hair loss. Skin has a large amount of Reductase enzyme - with the amount varying by location - the most where male pattern baldness occurs. Currently, a way to avoid hair loss while keeping virilization is to use a topical agent which blocks DHT - thus keeping a high systemic level for virilization, and keeping a low skin level to keep hair. This doesn't always work. Unfortunately it is the state of the art.

 

[Axl]

Hi Marianco,

Thanks for the info. I think my body is able to make DHT: when I inject 250 mg T enanthate every 10 days, I see a rise in my androstenedione gluceronide levels, which means my body is converting T to DHT, right?

I have heard some of my old endo's mumble something about me lacking a lot of "Androgen receptors". Do you mean the same when you talk about testosterone receptors? So I should try to take the DHT to the max, if I want to get some more masculine features such as a more masculin face or beardgrowth or hair on my arms? So Growth Hormone has no role in it?

What is the topical agent that blocks DHT and slows down the male pattern baldness? Is it Nizoral you are talking about? Is there a way to increase the number of AR receptors in my body? That would be a valid option as well, wouldn't it?

Axl

 

[love_en]

If you have not done so already, a total DHT test might be needed. I know Dr. Crisler does one after starting a patient on TRT. If 5a reductase deficiency is a problem, then no amount of T will induce hair growth. Isn't there a transdermal DHT used in Europe for treating gynecomastia and as a androgen replacement?

 

[coz]

If you have not done so already, a total DHT test might be needed. I know Dr. Crisler does one after starting a patient on TRT. If 5a reductase deficiency is a problem, then no amount of T will induce hair growth. Isn't there a transdermal DHT used in Europe for treating gynecomastia and as a androgen replacement?

Yes, the transdermal DHT gel in Europe is call Andractim, it's a 2.5% DHT gel.