I’m going to explain Gel based testosterone in more detail. What version of TRT that you are on is a controversial subject as some GP’s and Endos, in every country around the world have differing ideas of what is best for the patient. Some GP’s and Endos really know their stuff when it comes to Klinefelter’s and TRT and will investigate to ‘nth degree whether a version of TRT is working or not and will change said medication to help the patient. Others will not. Whether this is down to lack of knowledge or their hands are tied as to what they can prescribe – we don’t know.
In the USA, Androgel is an FDA approved TRT gel. It is available in 1% and 1.62% strengths. Androgel 1% comes in 5 g (50 mg testosterone) and 10 g (100 mg testosterone) packets whereas Androgel 1.62% comes in packets and a pump version. One pump press equates to 20.25 mg of testosterone in 1.25 g of gel whereas the packets come in 20.25 mg and 40.5 mg of testosterone in 1.25 g and 2.5 g of gel.
Androgel 1% must be applied to either the shoulders, upper arms or stomach areas whereas Androgel 1.62% must only be applied to shoulders and upper arms. Gel should not be applied to the genitals, chest, armpits or knees.
The starting dose for Androgel 1% is 5 g of gel (50 mg T), applied once daily in the morning. Androgel 1.62% starting dose is 2 pumps, 2.5 g of gel (40.5 mg T).
In the UK, Testim (contains 50 mg of Testosterone per sachet), Testogel (contains 16.2 mg of Testosterone per gram) and Tostran (contains 20 mg of Testosterone per gram) are all controlled substances.
Testim contains several inactive ingredients – Ethanol (approx 74%), Carbomers (980 and 1342), Trometamol, Pentadecalactone, Macrogol 1000, Propylene glycol, Glycerol and Purified water.
Testogel contains – Carbomer (980), Isopropyl myristate, Ethanol, Sodium hydroxide and Purified water.
Tostran contains – Propylene glycol, Ethanol, Anhydrous, Isopropyl alcohol, Oleic acid, Carbomer 1382, Trolamine, butylhydroxytoluene (E321), water, purified and hydrochloric acid (for pH adjustment).
Directions
Gels are applied daily, preferably in the morning after showering, ensuring that your skin is thoroughly dry before application. The gel is applied either to the shoulders, arms or stomach (or as directed) and left to air dry. Whilst the gel is drying, wash your hands thoroughly with soap and hot water.
Make sure that nobody comes into contact (especially women and children) with the applied areas whilst the gel is drying and certainly not until you have covered the applied area with clothing.
Precautions
Do not use any of the above gels if you are allergic to any of the ingredients in each of the products.
It is important that you do not touch or hug women with any of the areas that the gel has been applied to as skin to skin contact can transfer the gel to them, possibly causing unwanted side effects such as facial and body hair growth, deepening of the voice, acne or changes in the menstrual cycle.
Children, whose bodies are still developing are more at risk from the effects of coming into contact with testosterone gel. These effects can include increased anxiety and aggression, early puberty, increased sex drive, frequent erection in males, enlarged clitoris in females and stunted growth.
Pregnant women are also at high risk as skin to skin contact could cause damage to the baby or a miscarriage.
Advantages
Gels provide a daily, pain-free method of elevating your testosterone levels. The products are easy to use and apply and if you adhere to the guidelines will provide you with trouble free testosterone treatment.
Absorption is through the skin causing testosterone levels to fluctuate which mimics the body’s own production of T.
Disadvantages
Absorption through the skin may be inefficient (i.e. when I was on gel, right at the start of my diagnosis, using Testogel, my levels dropped from 6.8 nmol/L to 3.8 nmol/L over a 2 month period).
Gels can cause elevated DHT levels which in turn produces oily skin. Other disadvantages include not being able to wash or engage in vigorous exercise for several hours after application.
For instance, if you are the type of guy that wakes, showers in the morning, applies your gel and then hits the gym and then comes back and showers again, you can wash off some of the gel, thus reducing your dose and you can’t reapply your gel until the next morning.
