EVERYTHING You Need to Know about Testosterone Cream for Men - dr Keith Nichols

Dr Keith Nichols shares his knowledge and experience on how to use compounded testosterone cream for scrotal application in men. What's the ideal protocol and dosage? Why on the scrotum / transscrotal? TRT cream vs injection: what is the best method of testosterone replacement therapy?
📘 ➜e-book: "The Ultimate Guide to TRT Cream" Why Compounded Testosterone Cream is the BEST option for TRT, by Dr. Steven Devos MD
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0:00 intro
1:14 Transscrotal cream vs injections
4:13 Compounded TRT cream Benefits
6:26 How to use testosterone cream correctly
13:27 Should you worry about transference?
16:41 Measuring testosterone levels (on TRT cream)
20:38 What total and free T level are we aiming for?
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*Disclaimer: This video and comments are meant purely informational! This is not medical advice! If you are looking for medical advice always contact your own doctor.
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[@TRTandHormoneOptimization]

✅ *➜Watch This Next: "Endocrine Disrupting Chemicals (EDCs)"* kzbin.info/www/bejne/r5vJYWyrgaiKmNk 📘 *➜e-book: "The Ultimate Guide to TRT Cream" Why Compounded Testosterone Cream is the BEST option for TRT, by Dr. Steven Devos MD PhD:* www.trtandhormoneoptimization.store/listing/e-book-the-ultimate-guide-to 📘 *➜e-book: "Acne on TRT", by Dermatologist Dr. Steven Devos MD PhD:* trtandhormoneoptimization.store/listing/acne-on-trt 🔶 *➜JOIN this channel to get access to perks:* kzbin.info/door/oLNk-4LAYsbfsQwjFWG2gQjoin 🏋🏼 *➜Best workout split on TRT:* trtandhormoneoptimization.store/listing/workout-program-for-men-on-trt

[@shopteststore]

Thanks!

[@MrScorpio110368]

Doc im interested in get into the action.. What brand of cream you recommend?

[@Turn420]

Applying cream is literally the easiest thing I do every day of my life. If you are tired of injecting give cream a try. I can definitely see myself doing this for the rest of my life.

[@ninjaworrier7308]

Glad to see Dr. Nichols on this channel again!

[@TRTandHormoneOptimization]

100%

[@liftingdermatologist]

yes!

[@SuperConsie]

This channel is the best online TRT resource by far. Thank you from one very grateful viewer.

[@TRTandHormoneOptimization]

Thanks so much!

[@asgerdanielsen567]

Great great video. I am about to start on a compounded 20% cream and all though I had found a lot of the info from this video beforehand, it was very nice to have it all together and explained so well.

[@Optimization_Coach]

Good to see Keith after so long. Hope all is well in Chattanooga

[@TRTandHormoneOptimization]

@hormonesmatterPhD , Thank *you* for watching and *commenting* !!👍

[@liftingdermatologist]

yes!

[@eternalson9797]

I started a month ago on the cream with 3 clicks in the morning only and my total T was 1340 and free was 254. It definitely works.

[@TRTandHormoneOptimization]

@eternalson9797 Thank you for sharing!

[@Carnivore-Sean69]

I do 3 clicks two times a day.❤

[@nicoc7024]

When did you test blood?

[@eternalson9797]

@@nicoc7024 after cream had been on about 5 1/2 hrs.

[@RAR88159]

@@Carnivore-Sean69what were you levels? I just started this same dose

[@dam54]

Epic video

[@TRTandHormoneOptimization]

I appreciate that, @dam54

[@mumenrider862]

I just went through bloodwork and doc consult with a TRT clinic in my area. They said they have creams available, but are pushing injections really really really hard. I asked if the cream was compounded and applied to the scrotum? They said no. So what other creams are out there? I told them over and over I don't want to do injections. But he said "we're a small shop and we have to limit the options we have through our pharmacy." The more I talked with him it almost sounded like a scam.

[@marlinpruett8343]

I've been using the cream for about 2 years now It is fair expensive it's a 3-month supply for $150 but it does work makes you feel a whole lot better too And I put it on at night instead of the morning because you know you sweat during the day so I just figured it's better for the night time

[@howden2010]

Any clinic recommendations near Toronto Canada that isn’t going to put me on an AI?

[@brandonjames8631]

Cream is king ! Especially when paired with micro injections on the daily as well !! I have found that I can’t do more than 50 mgs of cream or I’ll be a snappy sob ! Wish you all or Keith would talk about the other areas it can be applied to besides nut sac

[@TRTandHormoneOptimization]

@brandonjames8631 Thank you for sharing!

[@keithnicholsmd6896]

I did. I mentioned that you could apply anywhere that you have skin from head to toe. And I meant that literally. People can apply to their face or forehead, neck, shoulders, arms, torso, upper inner thighs, tops of their feet, etc... But I explain that we use the scrotal application because we typically get our best levels there and it decreases our risk of transference to children or animals

[@Billybawse]

Can this cream be purchased in Australia? Does it need to be via compounding pharmacies? What about if you want to maintain your body's ability to natural produce testosterone (fertility reasons), what do you suggest taking with it (ie enclomiphene etc)?

[@jmf420]

I’ve been doing 4 clicks in the morning, on my shoulders and inner bicep, and have felt amazing. Atrevis base. Doing bloodwork in March so I’ll be interested in seeing the numbers

[@MohamedAli-yu5ys]

Did you get the results?

[@jmf420]

@@MohamedAli-yu5ys yep 825 total, 170 free at 5 hours after application. I know the numbers would be higher if i applied to my scrotum but I honestly feel a lot better doing it this way. Doc cleared me to add one more click which i have done as of this week and i can definitely feel a difference. Got to get used to it again but still feel really good. Was at 121 total and 18.5 free prior to starting trt

[@Mystery-Moon]

What brand ? I use Androgel.

[@jmf420]

@@Mystery-Moon gels are garbage. You want a 20% compounded cream from a good compounding pharmacy. I use an atrevis base 20% compounded cream from Medquest Labs in Utah

[@jmf420]

@@MohamedAli-yu5ys yep. 6 hours after application, my total was 870 and free was 175. My doc cleared me to add one more click which in theory should get my total above 1000. Will do more bloodwork later this year but feeling really good. My total prior to starting was 121 and free was 27 so there is a significant improvement in my numbers

[@drewgrows7765]

You mentioned better absorption on the scrotum. Makes me wonder why my Androgel says on the instructions not to do that. Shoulder and upper arm only. It is alcohol base.What happens if apply the Androgel down there?

[@Rollercoastr13]

Don’t do it, it burns. This cream is designed differently.

[@ZaUvek1]

I've been using a cream for a few months and the problem has been applying in the morning. I normally surf first thing and then go to the gym after, so it's a long time before I can apply. So now I'm just applying at night, hoping it's still going to be effective

[@keithnicholsmd6896]

You could just apply it later in the morning and then later at night as an option. Or you could just do it once daily which I discussed in this video. A lot of men are perfectly fine just doing it once a day.

[@andyharris3084]

Does anyone know where you can get this TRT compound cream in the UK?

[@manuvier8967]

NP Labs in description of this video. They ship worldwide

[@TRTandHormoneOptimization]

🧪 ➜Use this link to get a 5% discount on your first order at online pharmacy NP LABS: compounded Testosterone cream, Pregnenolone and DHEA capsules, Testosterone enanthanate, Mesterolone tablets, Tadalafil capsules, high dose Melatonin, PEPTIDES, and much more: admin.nplabs.online/register/patient?afid=2a38a4a9316c49e5a833517c45d31070

[@JM-gn5vu]

is the lipoderm base good for scrotal application? using 200 compounded cream, lipoderm base

[@TRTandHormoneOptimization]

yes

[@kennym99]

Dr how often do your patients say the evening application creates sleep disturbances? I seem to be going through the same, but I am also on thyroid meds. I'm only doing 2 clicks per day. Would you feel say I could do 2 clicks in the morning?

[@keithnicholsmd6896]

You can either give it time because it will resolve in a lot of men with just time. Or you can just do all of your application in the morning. A lot of men do perfectly well that way

[@JerryGarciaPOBox]

Is this the gel that my dr told me to put on my arms/shoulders? It's a slippery, clear, generic "Androgel". I read the paperwork and didn't see anything about scrotal applications. It seems like application location is primarily concerned with transfer during sex

[@TRTandHormoneOptimization]

No, it is not the gel

[@robertworton2394]

Do I apply with the bottle where the little side with holes on? Or should I use my fingers

[@keithnicholsmd6896]

Use your index and middle finger just like in the video. Wash your hands afterwards.

[@darrinuhl8103]

Awesome video. He said 30-60 Free T is optimal range for most? What does that equate to in pg/mL? (The official Reference Range is listed as 46 - 224 pg/mL). I’m bad at math, can someone explain the transition in numbers?

[@keithnicholsmd6896]

300-600 pg/ml

[@TRTandHormoneOptimization]

Thanks for helping out, friend

[@keithnicholsmd6896]

@@TRTandHormoneOptimization anytime, my good friend. Great seeing you again!

[@Blkout2k1]

@@keithnicholsmd6896 That's an insane amount of free T if that conversion is correct. The Dr had to have misspoke. I have never seen free T levels that high even when I was on a supraphysiological dose of TRT injections.

[@keithnicholsmd6896]

@@Blkout2k1 then you've never had an optimal level of free testosterone. That amount of free testosterone correlates with a total testosterone between 1,000 and 2000 ng/dL in most men. The free testosterone reference range that the previous commentor listed as 46 to 224 pg/mL equals out to be 4.6 to 22.4 ng/dL. That's similar to LabCorp here in the United States for the normal range is 5-21 ng/dl or 50 to 210 pg/ml when converted. Unfortunately you like many others, including myself in the beginning were brainwashed by the so-called normal range. What is insane is that the normal range for free testosterone is insanely low. Do you realize where that normal range came from? Well you can't find it out because LabCorp and quest here in the United States derived those normals internally. They did not come from any study, nor do we have any data on the health of the men were they derived these normal ranges from. So they're basically secret normal ranges. There was a paper published in 2022 in the journal of andrology, looking at healthy normal men between 19 and 39 years of age to determine free testosterone levels. What they found was that the normal levels for these men were 120 to 368 pg/ml or 12 to 36.8 ng/dL. So now 300 to 600 pg/ml doesn't look so insane does it? We will be talking about supraphysiologic in an upcoming video.

[@anontablet6304]

As the half life of cream is quite short does that translate into any better maintenance of fertility via LH and FSH?

[@keithnicholsmd6896]

No, anything that significantly increases testosterone will suppress your own production

[@gary_michael_flanagan_wildlife]

Hi Dr. Nichols. Thanks for the video. I am going to be 43 years old in October. I am in really good shape, lean and muscular but I know my test levels must be low because I am always tired and lack drive. I was thinking of using a online clinic like TRT nation which costs $100 per month, plus blood work. I think they use cypionate. If a cream worked just as well I would be loving not having the hassle of injections every 3 days at home. Do you think the cream can be just as effective? Can it cause more hair loss? I have a full head of hair so I don’t want something to cause this if injections are less likely. Do you see any reason why injections would be better? Also I know empower pharmacy makes the cream you are showing but how would I get a doctor who uses them? Do you know who I can go to or recommend who uses the pharmacy? Thank you for your help. I’m not necessarily looking for the shortcut or easy way but if you can show me a path aside from TRT nation I am all ears. Thank you doc!! Gary

[@keithnicholsmd6896]

I've done videos on these very topics on this very channel so please go see the DHT video. No matter how you raise testosterone or more specifically free testosterone whether it be injections or cream, you're going to accelerate hair loss if you're genetically susceptible. So with optimal levels of testosterone no matter what method of delivery will cause hair loss in those predisposed. The cream works as good, if not better than injections for most of the men that I see including myself as well as dr. Devos. The continual propagation of misinformation, stating that cream does not work as good as injections is a false narrative, and I prove it every day. My point has always been that there are two good ways to get testosterone, and that is injections and cream, and that they both work. My issues is with those that say cream doesn't work because that is not correct and maybe it doesn't work when in the wrong hands. And I would recommend you see an actual physician and not an online clinic. You get what you pay for. You know you're dealing with a testosterone mill whenever there's no physician listed on their website. There are many good TRT providers out there that on their own clinic where you can get personalized services. Who is the doctor for TRT nation? What's his training and how often we get to talk to him personally? Almost all good TRT physicians now do telemedicine.

[@gary_michael_flanagan_wildlife]

@@keithnicholsmd6896 thanks for the detailed response. It must be frustrating to hear the blanket statement that “creams don’t work”. I have heard this for many years now too and this video really changed my mind. I always thought the creams were an easier way out and for people who were needle averse but it’s clearly not the case. I don’t mind either method, I just want to feel better and have more motivation. From what I understand a lot of the online clinics have a urologist look over your lab work, then provide a treatment plan at home after a telemedicine visit. I’m tired of researching this to be honest. I know what I need to do. I’m just trying to find the best option that is both affordable and straightforward, reputable. In this space there are so many options so I’m trying to be cautious but will make a decision soon.

[@mattmason4589]

If you apply once daily, how much would you say the fluctuations of points. Is. 1400 ngdl down to 700 ,24hrs later?

[@arthurfonzarelli9828]

I doubt it would drop that much but I think he does want you at high levels and to keep that up you do have to probably apply twice a day or you'll probably drop probably 100 points or so a day I would assume

[@jasonseason8223]

Approximately, how much does it cost per month if you use cream? I know each person has different doses, but curious if there was a price range like 1 click BID to 3 clicks BID. Thanks!

[@TRTandHormoneOptimization]

We have 2 videos on the cost of cream / TRT: kzbin.info/www/bejne/o6q9eHSCiM9qm6ssi=Ys5tFuUtorfcv7PP and kzbin.info/www/bejne/rHunpqyIo7R3p9Esi=yITmlIfxzmIuJXlJ

[@patrickpatrick9132]

I’ve had pellets, injection and cream. Cream works best for me.

[@keithnicholsmd6896]

I agree with you as I've had all of those as well

[@user-xi9vj9hn7b]

How long does it take for the cream to dry?

[@keithnicholsmd6896]

@@user-xi9vj9hn7b it's in a disappearing cream so you rub it in and it disappears and you go about your day. It takes me approximately 11 seconds. The HRT base doesn't leave any residue and doesn't need to "dry ". It's no different than putting sunscreen on your face. You rub in the sunscreen and then go about your day.

[@patrickpatrick9132]

@@user-xi9vj9hn7b just a couple minutes.

[@28copland]

Does hermaticrit and haoemaglobin on creams go up same as injections??

[@keithnicholsmd6896]

Yes, and there's no harm in that. Will be doing a video on that very shortly.

[@28copland]

Thanks appreciate it

[@JohnPiperBoots]

QUESTIONS PLEASE - I am 68 pretty good health my T = 292ng/DL Free T = 12.5pg/DL. I am interested in the cream. My PCP not recommend he says (normal range for me) he says cause cancer. Seeing urologist in 2 weeks. I have no libido, fatigue, muscle recovery slow etc On Reddit sub many guys in 50s 60s on TRT injections or cream and are doing well with T 500ng/DL or more. Feeling great like 20 years younger. What do I have to do or say to get a Rx? Would be awesome to roll back 20 years and ALL benefits of T. Help? Suggestions? I subscribed too. Thanks much.

[@MrGreeny1911]

Tried compounding cream for two weeks after 2 years of cypionate. Thought I was going crazy. Up and down all time during the day mostly down though. No friggin bueno.

[@keithnicholsmd6896]

You are another example of someone having it done incorrectly to them. Never see that in my practice.

[@MrGreeny1911]

Yet when on test discussion boards lots of guys who don’t like cream… for many reasons including feeling like poop on the stuff. To be fair many sides with all forms of test that no doctor will admit to. the discussion boards full of those guys. But of course it’s not the test it’s just administered incorrectly haha. So many variables which start at the compounding pharmacies. After two years of bloating on cypionate in grapeseed oil. But oh wait you can’t be allergic to it it’s such a tiny amount. Hahaha. Dollars for donuts my cream isn’t blended properly. It doesn’t even come out consistently. If my cypionate is dialed in to the milligram yet the cream comes out in random amounts… two clicks not enough three way too much.. yeah all the guys fault.

[@dougage1]

Thanks for the video!!! What sort of period of time does it take for cream to stabilize in the body?

[@keithnicholsmd6896]

Peak absorption occurs within about three hours and then it drops about 25% from Peak at 12 hours. So when we do a twice daily application there's no significant peak or trough. The levels are stable as soon as you start taking it as long as you are consistent with your application.

[@dougage1]

Thank you for your response Kieth. That’s good to know. So it’s not like injecting an ester like Enanthate which can take 35-45 days to reach steady state?

[@keithnicholsmd6896]

@@dougage1 it reaches a steady state in days. That's what's great about the cream, but that can be a fallback for some that are not consistent with their application. If you apply it consistently in twice per day, you will have consistent levels day in and day out. If men miss a lot of doses within their levels will not remain stable.

[@dougage1]

Perfect :) thank you

[@TriggerTravels]

​@@keithnicholsmd6896 I have tried both 20% cream and injections. I find that test makes my sleep apnea significantly worse... Which makes me feel worse during the day. Testosterone has a natural diurnal rhythm... Higher over night and into the morning dropping down in the evening. Since I seem to be sensitive to test with my sleep apnea do you think it's better I stick with a once daily application of the cream in the morning so my test levels are lower at night? So possibly won't affect my sleep apnea like injections do since injections just give you a constant release.

[@davecarroll171]

Any side effects of taking 200 mg/mL in the morning I was on 100 and dock up to 200

[@keithnicholsmd6896]

The answer to your question is if you still had symptoms that require you to increase your dose then you increase your dose and you see if you have any side effects. There's no way to predict side effects. You address side effects if or when they occur. It's a balancing act between raising levels to resolve symptoms while avoiding any unwanted side effects.

[@krane15]

If you don't have a few minutes a day to treat your dysfunctions, then you probably don't have a true issue with low test. No one want to feel like the walking dead all day. I sure know I don't Anyway the only question I would ask is how do you determine what is symptomatic improvement? In other words, do we aim to optimize levels or are we out to simply minimize the symptoms? To use coffee (caffeine) as an example, one cup of coffee in the morning will remove my lethargy. But two cups will give me a greater stimulation and awareness to perform a much greater amount and variety of tasks. Including tasks I'm not used to or familiar with. To use numbers, that would be 600mg caffeine to achieve maximum awareness and focus optimization. However, at 800 mg it increases my anxiety so much that I become agitated and jittery. I actually lose the ability to concentrate and focus. Its at that point that I feel that I've reached the point of diminishing return. Optimization or minimum symptom relief? What do you think?

[@keithnicholsmd6896]

You're describing how it actually works without realizing you're describing how it actually works. We treat men with a trial of testosterone therapy for symptoms. We think may be related to low testosterone levels in them. We therefore raise their levels and follow symptoms. So we treat with a starting dose and then follow at six week intervals with repeat, labs and symptom questionnaires. We are not aiming for a specific level but when most men get symptomatic improvement, their free testosterone is typically between 30 and 60. If we get a free testosterone, let's say 50 or 60 and they are still symptomatic. Then their problem is not related to testosterone, and raising it any further will not be beneficial. There is a plateau to the field good effects of testosterone, and this is explained in an upcoming video. And what you were describing with coffee is exactly what we do with regard to Testosterone. We raise levels and balance that against avoiding any unwanted side effects. It's just a simple, balancing act. You find the levels that improve symptoms and the patient doesn't have side effects. Just like you did with your coffee. You can tolerate 600 mg of caffeine but you can't tolerate 800. Same holds true with men and their testosterone dosage. So your question was very good, and it will be answered in an upcoming video. Yes, there is a plateau to the feel Good effects of testosterone were raising it past a certain point in a given man will provide them with no benefit in how they feel.

[@JM-gn5vu]

When you open the topi click container to use the remaining testosterone cream with a screw driver, how do you measure your dose?

[@TRTandHormoneOptimization]

If you are used to seeing the quantity you usually use, you surely can take the quantity on sight, no?

[@JM-gn5vu]

@@TRTandHormoneOptimization your right, thanks.

[@MarvinWafflehouse91]

I’ve been on the injections for 6 years …after having a 4” gash in my arm from surgery I hate giving myself a shot in that shoulder …I’m going back to the doc Friday for my 6month checkup…so I ask for the hrt base transcrotal cream correct ? is there a specific name other than that ? Thanks

[@keithnicholsmd6896]

Make sure he has some experience with utilizing it or he won't utilize it correctly. It will be a 200 mg/gm concentration and you can start by applying 100 mg twice per day. I recommend the HRT base.

[@asgerdanielsen567]

Mine is called Liposomal Bioidentical testosterone cream. It is not a brand but instead made by a compounding pharmacy on my doctors instructions.

[@MarvinWafflehouse91]

@@asgerdanielsen567 thanks

[@MarvinWafflehouse91]

@@keithnicholsmd6896 she had no clue …I’ll be trying to come see you in a few months ..I had no clue you was close by 👍🏼

[@mrroboto1660]

Hey guys love your channel and thanks for all the excellent advice. Overall T 305 ng/dl Free T 59.4 pg/ml 44 yo male Primary care did refer me to an Endocrinologist ( after I pressed the situation ) Endocrinologist could barely have a conversation with me because my levels are in range and I have a sex drive. Do I just keep making calls and appointments until I can at least talk with someone like you. My diet is good, alcohol 1 to drinks a week not sessions, I’ve been going to the gym and recently lost 45 pounds with exercise and diet. Sex drive is fine, mode and tiredness are the main problems. I work hard long days small business lots of stress. Just want to be sure my hormone levels are optimal for weight control, muscle retention / growth mood and energy. Any thoughts would be greatly appreciated Thanks

[@keithnicholsmd6896]

All you have to do is give us a call and your problems will be solved. That is not a good free testosterone level whatsoever. Help is out there you just need to make the call

[@DakTirCue]

Im doing twice a week IM and TBH, I cant stand the injections.. I plan on moving Knoxville soon and it looks like It might be worth the trip down to Chattanooga . Maybe open a satellite office in Knoxville? ;) The ease of traveling almost makes this a no brainer.. How long does a tube last at 2 clicks 2x/day? A month?

[@eddiebyrd7128]

Dr. Nichols does telemedicine.

[@kpgramps3544]

It appears that your e-book isn’t available?

[@TRTandHormoneOptimization]

It is. Link: teespring.com/e-book-the-ultimate-guide-to?tsmac=store&tsmic=trt-merchandise&pid=1447&cid=104726

[@TRTandHormoneOptimization]

Both links work for me: www.trtandhormoneoptimization.store/listing/e-book-the-ultimate-guide-to

[@kpgramps3544]

Ok, I see the “Add to cart” button now. Thanks!

[@MohamedAli-yu5ys]

I have 2 questions: I got prescribed the scrotal creme: 100mg morning, 100 mg evening but I suffer from insomnia. Will it be an idea to take the 200 mg dosage once in the lunch time to avoid the impact on sleeping? How to avoid hair loss?

[@keithnicholsmd6896]

Just apply all the dose in the morning. Many men do that due to impaired sleep (which actually usually improves with time). Use high dose melatonin along with L Theanine and GABA at night to improve sleep if using twice per day

[@MohamedAli-yu5ys]

@@keithnicholsmd6896 : Thank your for your reply, I appreciate it. Do you have any recommendation for avoiding hairloss besides taking Finesteride - I am afraid to get post FS in long term thats why I dont want to take it. I have heared that a strategi to avoid hairloss can be apllication other places than scrotum - what is your experience on that? Other tips to avoid hairloss? Thanx and great video by the way.

[@keithnicholsmd6896]

@@MohamedAli-yu5ys red light therapy and there are two companies that I like and I in fact have a helmet from I restore and then there is I grow. There's also platelet rich, plasma injections, hair transplants, and the topical solutions consisting of a mixture of minoxidil and finasteride which doesn't cause the systemic issues that the oral does. It doesn't matter how you get testosterone or where you apply it it's going to cause hair loss and those that are susceptible. It's not the DHT in the serum as I just did a video on this very topic so please go see that video. It's the free testosterone that acts at the hair follicle where it is converted into DHT that cause hair loss.

[@RickyRyan]

@@MohamedAli-yu5ys To mitigate sleep issues: Take your second dose 6 hours after , see how that feels. For hair loss, if it’s significant. Apply the cream to the back of the knees. Solve that problem for me when I was using the cream.

[@jessperna7916]

@keithnicholsmd6896 Extremely informative video! What is the reason cream boosts libido more than injections in so many men?

[@keithnicholsmd6896]

It just simply raises free testosterone levels better for every given total and the same man compared to injections and also with a twice daily application you have consistently optimal, free testosterone levels with no significant peak or trough whatsoever. And with that higher free testosterone level, you're going to have, a better increase at the tissue level of the active metabolites DHT and estradiol, therefore increasing the benefits of testosterone in those tissues, such as the brain, the bones, the heart, the blood vessels, and the reproductive organs.

[@JerryGarciaPOBox]

Is the same true of gel? ​@@keithnicholsmd6896

[@darrinuhl8103]

1. With the peaks, troughs, and short half life of cream, what if you travel and forget it for a few days? (Will there be sharp drop offs?) 2. Is the best starting dose 100-150mg per day or per application?

[@keithnicholsmd6896]

Well to answer your questions your provider will start with the dose that he thinks will get your levels in an optimal range efficiently. Different providers will have different starting doses. It depends also one of the man wants to take a low and slow approach or if you would like to get his levels optimal very efficiently. So the initial dose will depend on those factors. I found that a dosage of 100 mg per application works quite well for most men. Look at the great thing about the cream is that you can change dosage and levels on a dime. So you can raise levels by just simply increasing the dose and those levels will go up in a matter of an hour or two. Also, the other side of that is that if you don't take it your levels are going to drop. If you don't take it for a day or two then your levels are going to be less than one to 200. But in a mature man, they don't really notice that because all of us have stopped it for some reason or another for several days or even a week or two or more at a time and we didn't really notice anything. Now that's going to run contrary to what you read on the forums where those are nothing but weak men for the most part. And lastly, when you travel don't forget it. It's the first thing that I pack and I keep it with me in my carry-on luggage or backpack so it never leaves my side. No different then I don't go on a trip without my wallet I don't go on a trip without my testosterone.

[@darrinuhl8103]

@@keithnicholsmd6896 that makes sense. Thanks again for helping us to understand the cream.

[@noelhoward2032]

Does the cream raise Hematocrit like the injectable testosterone?

[@TRTandHormoneOptimization]

Hematocrit is level dependent, not dependent on how that levels is reached (administration route)

[@andre.shaw91]

Cream did NOT work for me and I know others have the same issue. All it did was raise me DHT 4x the top of the natural range and lower my T to the bottom of the natural range. My FSH and LH were reduced to almost nothing. Having my DHT this high gave me terrible insomnia! I think that a lot of guys who use cream and have poor results would find this to be the case if they measured their DHT. My protocol was 1 pump (50mg) on scrotum and 2 pumps on shoulders in the morning. You could argue that I just needed more cream, but no way would I want my DHT any higher than 4x higher than top of the natural range! I’m not looking for super physiological levels of DHT, I’m looking for T to just be at the upper limit of the range

[@keithnicholsmd6896]

Another video coming on the topic of DHT. The DHT did not cause your problems. The DHT that you're measuring the serum has no effect in DHT sensitive tissues. Evidently your doctor did not explain how testosterone works because when you take testosterone, everyone's FSH and LH is "reduced to nothing". That's what testosterone does when you take it. Your doctor probably did not have a very good compounded cream as well. You do not understand how DHT works but there's going to be a video upcoming to explain it. The problem is that you're going to a clinic where the provider has not adequately explained testosterone, DHT, and how testosterone works from a physiology standpoint. Testosterone causes insomnia in some men and it's not the DHT because it occurs as much is people that inject as people that use cream. You're blaming your problems on the DHT but it's not the DHT which once again will be explained in an upcoming video. You just didn't have a good provider.

[@federicomanzella3729]

The problem is application on shoulder 😂😂😂... only scrotal 2-3 time for day... only scrotal

[@chrisavalis1494]

Is 2 clicks in 10pct cream at 100mg a effective enough dose?

[@tylergood1223]

Depends on your absorption. Could be

[@MrClean-uf5rp]

I believe most prescriptions are 20% T. So factor that in when you hear discussions of clicks. Of course absorption and effectiveness will vary for everyone to some degree but I assume you'd be using double the clicks of someone on a 20%, unless, of course, you are prescribed the 10% and a lower dose for a reason.

[@jlingo8977]

I am having problem with cream. It didn’t properly absorb.

[@keithnicholsmd6896]

If you're in the United States, use MedQuest pharmacy and have your doctor utilize the HRT base and it will absorb great

[@sharonphillips3700]

How do we get the cream?

[@keithnicholsmd6896]

You need to see a provider experienced in utilizing it. Most all of us do telemedicine now

[@sharonphillips3700]

@@keithnicholsmd6896 do you know who could take a new client that does the telemedicine?

[@user-wt9fo5sx5s]

I developed a rare side effect from the injection that being the opposite of what to expect. Unusual tiredness or extreme fatigue. Will I have the same side effects on the cream?

[@keithnicholsmd6896]

You need to have all your hormones evaluated especially your thyroid in order to answer that question.

[@user-wt9fo5sx5s]

@@keithnicholsmd6896 I have had much blood work done.THS was normal at 1.66. lm 60 now but back in the day I took much more test with no fatigue. Several years ago I discovered I can't tolerate any amount of testosterone with out getting extreme fatigue. I have talked to the drug makers on the phone and they said fatigue is one of the symptoms that came up in the drug's trials with patients. Same with the cream. This fatigue is dabilatating and takes three months to start to go away. No matter how much I rest I never feel rested. I hope it's not permanent this time. Not everyone gets every side effect but people should be aware.

[@keithnicholsmd6896]

@@user-wt9fo5sx5s I don't have the ability to delete anyone's reply, as this is not my channel. But I don't think that Stephen deletes anyone's replies either.

[@keithnicholsmd6896]

@@user-wt9fo5sx5s fatigue is not a reported side effect any of the prescribing information for the oral testosterone, injectable, testosterone, or the transdermal testosterone. Worse than a fatigue is not a reported, side effect. You need to be evaluated for sleep apnea, the TSH is not a good indicator of clinical symptomatology but instead, you should be looking at your free T3 levels. When it comes to thyroid, you should have all your other hormones, a valuated, including vitamin D3 and DHEA and you should undergo micro nutrient testing such as the Spectra cell test to look at all your micro nutrients and minerals, etc. Studies on testosterone have shown the opposite with regard to fatigue.Studies on testosterone have shown the opposite with regard to fatigue... PMCID: PMC8823386 DOI: 10.7573/dic.2021-8-12. And there are no clinical trials with the cream as it is a compounded product and not commercially available. None of us have seen fatigue utilizing the cream though.

[@user-wt9fo5sx5s]

@@keithnicholsmd6896 Ok just wasn't showing on the phone but is now on the desktop. My apologies.

[@timmylangenberg]

MOET ik ook hebben. ASAP

[@TRTandHormoneOptimization]

Gebruik ik al sinds 2017

[@timmylangenberg]

@@TRTandHormoneOptimization Online te bestellen en af en toe bloed laten checken?

[@daviddavid1057]

Let's be honest, shaving the scrotum with the razor every day is a bit too much and not that healthy for the skin i think, every three - four days is more than enough if i have to do it with a razor anyway in my opinion! For the rest it was a great video and especially very informative, thank you very much Docs! 🙏🏻

[@TRTandHormoneOptimization]

@daviddavid1057 Thank you for sharing!

[@RedOakCrow]

You'd need the scrotal skin of Chuck Norris, but you'd prob have to throw away the razor after one use then.

[@daviddavid1057]

@@RedOakCrow lol 😁

[@liftingdermatologist]

Dank voor de comment, man!

[@daviddavid1057]

@@liftingdermatologist Jij ook bedankt Dok!👍🏻

[@MegaMarky82]

“The 4-5 inches between the ears is the hardest to treat” 🤣🤣🤣

[@Untarai]

10 seconds to apply!! ??? Man, I wish! I have been using cream for many years but it takes about 5 minutes to apply and make the cream absorb in the scrotum. I believe it is some form of Liposome base cream.

[@keithnicholsmd6896]

That’s why I use an HRT base which is called a vanishing cream. It literally vanishes in 10 seconds.

[@Untarai]

@@keithnicholsmd6896 I called my compounding pharmacy and asked about the HRT base vanishing cream and they said they have it but at concentrations of 20% it tends to breakdown but at 10% is ok. So they suggest an HRT Versa base that would also be a faster application and can be fine with the 20%

[@keithnicholsmd6896]

Your compounding pharmacy is giving you bad information. I’ve used every base available. I’ve been using the HRT base for over a decade in a 20% solution and it has never precipitated out. I suggest you contact Medquest pharmacy and try the 20% HRT base and you will see exactly what I’m talking about. Remember, I follow up with men every day that are on this base that have absolutely, beautiful levels. The versa base will not go in as quickly and will leave a residue.

[@Untarai]

@@keithnicholsmd6896 Thank you so much Sir! I will contact them for my next bottle. I am eager to try it. You are right. This HRT Versa base takes long to absorb and leaves a residue.

[@jmf420]

@@keithnicholsmd6896do you find medquest hrt base to absorb better than their atrevis base? That’s what i’m using currently

[@wheeliewheelie]

but can you really get above 1000ng/dl with cream...

[@TRTandHormoneOptimization]

Yes! Keith just send me a file with levels from many men on test cream: total T's of 1500-1700 and even up!

[@wheeliewheelie]

@@TRTandHormoneOptimization do you know the concentration and frequency of application...

[@churchofcreation8888]

It's like liquid gold 😂

[@macadam7819]

👍🏻💪🏻

[@TRTandHormoneOptimization]

@macadam7819 , Thank *you* for watching and *commenting* !!👍

[@liftingdermatologist]

Dank voor de comment, man!!!

[@malekmalek9064]

👍

[@TRTandHormoneOptimization]

Thanks!

[@liftingdermatologist]

Dank voor de comment, man!!

[@malekmalek9064]

@@liftingdermatologist keith das lang geleden,toen bestond uw channel nog niet lang

[@tangorealauditnz7706]

will Gel work or only cream

[@keithnicholsmd6896]

Depends on your needs. The cream is about 10 times more powerful than the gel the gel won't raise levels up enough to resolve symptoms in a lot of men.

[@tangorealauditnz7706]

@@keithnicholsmd6896 only gel is subsidized here. Testogel. 20mg a pump.

[@tangorealauditnz7706]

@keithnicholsmd6896 we only have TESTOGEL funded in nz..... Says not to use on nuts.... Because of alcohol content Carbomer Isopropyl myristate Ethanol Sodium hydroxide Water Contains ethanol: It may cause burning sensation on damaged skin. Its 20mg per pump says use two pumps

[@keithnicholsmd6896]

@@tangorealauditnz7706 that's exactly right and that's why in the video we say, do not put any alcohol-based product on your scrotum.

[@tangorealauditnz7706]

@keithnicholsmd6896 so how would u use the testo gel and how many mg per day. Says max 4 pumps which would be 80mg of gel

[@jwwilliams]

I wonder if it still helps with free t when you apply on other areas of your body other then your nuts? My free wont go much anove 20ng/dl with injections 3 times a week with 1200 total

[@keithnicholsmd6896]

As stated, in the video, you can apply the cream anywhere that you have skin from head to toe. It will raise testosterone levels, no matter where you apply it. It's just you get the best levels in most instances from the scrotal skin, and it reduces our risk of transference to children and animals. But yes, you can apply to the top of your feet, back of your knees, inner thigh, scrotum, neck, chest, face, etc...

[@jwwilliams]

@@keithnicholsmd6896 that wasn't my question. My question was whether or not you would get the same increased free t from other application sights.

[@keithnicholsmd6896]

@@jwwilliams as stated, in the video, you would just have to apply more testosterone. You get your best absorption from scrotal skin therefore, you'll get the best levels. If you want the same amount of levels, you're going to have to apply more testosterone to the other parts of your body.

[@jwwilliams]

​Yeah I was just wondering whether or not the ​scrotal skin area had some free t increasing capabilities that other parts of the body wouldn't. Ya know being that it's the testicle area and all. If that makes sense @@keithnicholsmd6896

[@Hash1985]

30-60 free T😮 that would mean a total T of 1500 to 3000!!

[@sgould6862]

And……? What is the problem you see with having a T level of 1500+? I went from 345 to 1450 in a matter of weeks. (With a 200mg application of cream.) My FreeT went from 4 to 57. I had every symptom of lowT you could name. I was a textbook case. ALL of my symptoms are gone. I feel like a man again. If the prospect of a high T level is concerning for you, I would recommend more research.

[@Hash1985]

@@sgould6862 didn't say anything wrong about it. Don't get so defensive... my levels are around 2000 smh

[@Blkout2k1]

He had to have misspoke, that's not achievable without a ridiculous amount of exogenous Test and cream will certainly not get anyone to those levels. I have never even come close to that level when my Total T was over 2000.

[@keithnicholsmd6896]

@@Blkout2k1 it's the easiest thing to do in the world and what I do day in and day out every day. There's nothing difficult at all about achieving a level of 30 to 60 ng/dL with the trans scrotal cream. But then, as we discussed in the video, no one in the United States, or the world, for that matter has more experience with utilizing the transcrotal cream. Those are very easy to achieve levels with a properly compounded cream that is then also applied properly. I could do a video sharing the hundreds of levels that I see on a monthly basis and show people how easy it is and maybe Steven and I should do that. If you remember, Steven has posted his levels before as have I, and both of us had levels of 15 or 1600 with a free in the 50s and 60s

[@Blkout2k1]

@@keithnicholsmd6896 I'm on 20% compounded cream for the last 9 months at 2 clicks per day, 2x per day my free T is around 10pg/ml, when I convert that to ng/dl, it's an insanely low amount. Even when I was on Test injections 2x per week, my Total T was much higher at over 2000, but my free T was around 30pg/ml which still converts to nowhere near 30-60ng/dl. Unless I'm missing something in the conversion from pg/ml to ng/dl then I don't see how it would be possibly to achieve 30-60ng/dl free T.

[@mikehinson5935]

I had a consultation with Dr Nichols after watching him on some vids on this channel and told him it’s how I found him. I told him I was not interested in cream because I have always used needles he refused to treat me. I told him I inject 2 times a week for years. Is almost like he was accusing me of using high doses although my blood work didn’t reflect that. Said this channel had got nutts and refunded me my 500 bucks for the consultation. So if you not willing to inject everyday he will not treat you unless you use cream. Just an FYI

[@charliebocchieri6486]

Don’t be a hen. I’m sure Steven and keith have talked out the issues they had like men. And are in a great spot now. Love or hate dr keith he has really helped push trt for a lot of men that weren’t doing great in the past. I hope we see more content from him on this channel.

[@mikehinson5935]

@@charliebocchieri6486Hen??? lol whatever. 😂 This comment isn’t for Steven. It’s for anyone who wants or is interested in Dr Nichols. If you don’t do exactly what he says in this video then he won’t take you as a patient. I’m certainly not trying to rehash whatever happened between these two. I know for me his protocol was nutty and I know not many guys would be interested in his protocol. I don’t care if he is on here or not. I will continue to support this channel but I will let people know what I said above to save them the trouble.

[@RAR88159]

I just had a consultation with Dr. Nichols and was provided the option between cream and injections so not sure what you’re talking about

[@mikehinson5935]

Yep, did he tell you every day injection or did you even ask. No reason to make it up.

[@RAR88159]

I was doing every day injections prior to meeting with him so I guess we were on the same page

[@Jared_D_]

He talks like a politician trying to get my vote

[@doneyhome]

Hi Dr. I recently started the cream 200mg/ml 2 clicks morning 1 click in the evening on the scrotum. Can you tell me if this cream is a quality one? Here is the brand and ingredients. “Humco HRT Cream is a topical cream used for hormone replacement therapy (HRT). It contains a combination of ingredients designed to provide relief from symptoms associated with hormonal imbalances. Some of the key ingredients include: Deionized Water: The base solvent for the cream. Glyceryl Stearate (and) Laureth-23: Emulsifiers that help stabilize the formulation. Glycerin: A humectant that retains moisture. Glycine Soja Oil: Derived from soybeans, it provides nourishment to the skin. Stearic Acid and Oleic Acid: Fatty acids that contribute to the cream’s texture. Cetyl Alcohol: An emollient and thickening agent. Paraffinum Liquidum: Mineral oil for skin conditioning. Lanolin: A natural moisturizer. Laneth-16 (and) Ceteth-16 (and) Oleth-16 (and) Steareth-16: Surfactants and emulsifiers. Triethanolamine: An alkaline ingredient used for pH adjustment. Tocopheryl Acetate: A form of vitamin E with antioxidant properties. Propylene (and) Diazolindinyl Urea (and) Iodopropynyl Butylcarbamate: Preservatives to extend shelf life. Carbomer: A thickening agent. Retinyl Palmitate: A form of vitamin A. Aloe Barbadensis Leaf Powder: Aloe vera extract for soothing effects."