tom

Hi,

Prior to going on testosterone my total T was 280 (280-800), free T was 9.5
(7.2-23) and estradiol was 32.9 (7.6-42.5). After 3 months of 75mg per day
of compounded gel my total T is 409,estradiol is 52 (0-76). This doctor's
lab didn't have free T test available instead had the FAI done. Free
androgen index (total T diveded by SHGB) It's 59 (14-94). I'm 48.

My questions are:

Although I have some increase in libido I still get few nocturnal,
spontaneous or morning erections. I'd like to up the dosage but because I
now see more hair in the drain, on my comb and on my shoulders and I'm
concerned that more T will cause more hairloss. Is that a correct
correlation? I never had any hair loss prior to starting T.

I started to get some gyno before I started T with some swelling in my left
"breast" and a small lump under the nipple. There's been no change since
going on T. Since my estradiol level is OK do you think I should still
consider Nolvadex? Would that do anything when estradiol is in the range? Is
it used long term?

tom

Androgenic hair loss is likely a hereditary condition. However it is not
given that if you had no loss prior to HRT, this trend will continue
after it. It all depends on the number of androgen receptors on your
scalp and how sensitive they will be to the increased androgen levels.
Unfortunately it looks like that the ARs in your scalp did not like all
this new testosterone. )

However there may be a way to lessen the likelihood of hair loss while on
HRT. Application of topical spironolactone may be the solution. You can
obtain this solution from Dr. Lee in LA:

http://www.minoxidil.com

There may be other doctors who sell this type of a solution but
unfortunately I'm aware of any others.


Also there is some research that suggests Nizoral shampoo may have some
anti-androgenic activity. So you may want to wash your hair and scalp a
few times a week with this shampoo.

There is a theory (how valid this is, I'm not sure) that Nolva does very
little for gynocomastia. Some anecdotal evidence seems to support this.

Likewise anectodal evidence suggests that an anti-aromatose such as
Arimidex, Femara or Aromasin are far more effective in treating this
condition.

Another solution may be the topical application of a DHT cream.

As far as these drugs being safe or not in the long term, who knows???

tom

Thanks for the input.

Tom