The two major testosterone gel brands are Testim and Androgel. They are very similar and generally prescribed interchangeably, but sometimes insurance won’t cover one or the other. Often, I hear that they won’t cover Testim and people want to know if Androgel is just as good. So here is a general guide to choosing – if you are lucky enough to have the choice – which one is right for you.
Testim Vs Androgel
I would try whichever your insurance covers first. If your insurance covers both medications, try whichever one has coupons or kickbacks.
Now that price and availability are out of the way, lets deal with smell: Testim smells. Some people think it smells good, and some can’t stand it. Either way, it’s a strong scent! Personally, I like it and my wife likes it. I’ve found that women ask me what “cologne” I’m wearing, and mention that they like it too. Still, if you or your wife don’t like the smell of something you have to put on every day, that would be a deal-breaker. So try out a tube and see what you and, if applicable, your partner thinks about the Testim scent. Androgel doesn’t have much of a smell at all.
Testim is sticky. Androgel goes on much like that hand-sanitizer stuff, while Testim seems to remain stickier longer. Some say this is why Testim seems to work better for them: Because it stays on the skin and “soaks in” better.
These personal statements of efficacy can’t be relied on as empirical data, however. But the fact that you can feel it on your skin longer, does bring up a question about Testim gel Vs Androgel: Does it take longer to soak in and, if so, does that increase the exposure time I have to worry about when it comes to my wife and children? The short answer is: NO. In-fact, according to US National Library of Medicine’s website, the wait-time for AndrogGel is much longer:
You should not shower, bathe, swim, or wash the place where you applied the medication for at least 2 hours after you apply Testim® gel or at least 5-6 hours after you apply AndroGel ®.
Waste
Testim comes in little single-use tubes so you go through more of them and it generates more waste. If you are eco-minded this may factor into your decision. Androgel comes in a dispenser with a little pump on it (like soap) so there is less waste.
But the real question when considering AndroGel Vs Testim is: Which works better? Which is the best? Which testosterone topical gel is going to get my testosterone levels on track fast, keep my levels steady, and keep me there for the long term since I’ll be taking this stuff for many years to come? As you might guess, both brands have their fans. Personally, I like Testim. And here is a study to back up my personal preference:
Efficacy of changing testosterone gel preparations (Androgel or Testim) among suboptimally responsive hypogonadal men.
Grober ED, Khera M, Soni SD, Espinoza MG, Lipshultz LI.
Division of Urology, Mount Sinai Hospital and Women’s College Hospital, University of Toronto, Toronto, ON, Canada.
Summary of the study:
A change in testosterone gel preparation among initially unresponsive hypogonadal men is justified prior to abandoning or considering more invasive TRT. Changing from Androgel to Testim offers hypogonadal men the potential for improved clinical and biochemical responsiveness. Changing from Testim to Androgel is indicated to eliminate or minimize unwanted side effects.
Note: This study was done to find out if switching brands would help men who were unresponsive to one brand or the other.
More important to me than such a study is to find out from others who have been on TRT for more than a year, preferably several years or more, and hear about their experiences with both or either drug. Please comment below with your own experiences.
I am inclined toward a weekly or bi-weekly injection over a daily testosterone gel application, but what does one’s rear-end feel like after being used as a pin-cushion for decades? I dunno… any bodybuilders out there want to elaborate on that?
I recently have been on Androgel. I don’t think you would have a problem at all with usability. Very dry, no smell. Here’s a summary of my experience:
July 14 – start at 5mg/day, abdominal application
July 21 – feel like I’m not on TRT at all
July 26 – feel slightly better having started putting it on my arms/shoulders and none on the abdomen
Aug 1 – feel normal again (normal being good)
Aug 11 – back to feeling like crap. T at 393. Started at 7.5mg/day as a result
Aug 23 – little better, lows aren’t as low but I didn’t feel like I was where I want to be on TRT
Sept 12 – back to feeling like crap. This is the start of some tremendous anxiety for next 2 weeks
Sept 21 – start 10mg/day
Oct 8 – I have not felt bad the past few days. Optimistic, happy, etc. Strangely my blood came back to T=160. My estradiol at 12. Can’t explain this one at all. My doc wants me to switch to Testim but since I have nowhere to go but up, I’m going off TRT for a while, and will focus on trying to keep my estrogen low (in hopes to raise my T). My estradiol is usually around 35, while T is around 360. if I can lower estradiol and get my T in the mid-400’s, I’ll be happy for the immediate future.
Up next if that fails is a decision between Testim and shots. I’m leaning towards shots, but am going to give it 4 months off TRT. Best of luck – Dave
Hello,
A third option is Striant (buccal method of t replacement). The gels are difficult for many esp. those of us who have transfer concerns. Also, absorption is an issue (was for me when on Testim). Striant gets my levels up by 300+ into the 550-600 range and it doesn’t have near the aggravation, etc of the gels. All things being equal (insurance pay, etc), I prefer Striant 10 to 1 over the gels! Good luck and keep posting.
There are four application sites for a reason. When using Androgel apply to upper arms, shoulders and abdomen, you need to really rub this stuff in because if its on your hands it is going down the drain when you wash them. Apply at the same time in Am after a shower and put a T shirt on after. 3 days to steady state 30 days and beyond for changes in mood and sexual function may need titration too. Stay with it but you need to apply it the right way.
I’m 67 and I have been experiencing extreme fatigue for well over a year. No sex drive and my penis seems to have shrunk into oblivion. After many tests the last one came back showing my testosterone level at 135 extremely low. Doctor has me on AndroGel 1% 50 Mg.Here is what I have noticed after 2 weeks of use. Upper arms are getting bigger and I woke up one morning with an erection. I am still fatigued to the extreme. I fall asleep in my chair at almost any time of day. I have no get up and go. Can anyone tell me what to expect? and in what order. In other words does it take months to see a difference in fatigue levels. Muscles, sex drive etc. Also does very low levels affect the size of your penis?
Thank you
Art
Art,
I’m not a doctor so I can only speak from experience. Also, I’m half your age so our results may differ. But when I first started taking Testim it took about two weeks for the levels to build up enough in my body that I was feeling consistently good day after day. It “should” take care of your fatigue, although you’re not going to feel like you’re 30 again (maybe 45-50 ?) and I have no idea about penis size. Maybe more frequent erections will bring back your flacid-length. Not sure. But if nothing else your balls are going to shrink, so it will look bigger in comparison. 😉
Thanks TRT Man I appreciate your help. Do you know what your testosterone reading was. My biggest concern has been with the fatigue….. I have slept as many as 20 hours straight. I just want my life back I also cannot lose weight I’m 5:8 225… No fast food chicken & Fish and I just cant lose it…. I sure hope this will do it.
Thank you again TRT Man
Art, I feel good when I’m over 500 (ng/ml or whatever it is) and like crap when I’m under that. I went on TRT after being around 200 to 300 for six months straight, and I felt terrible. These days I try to stay between 600 and 1,000 and I feel GREAT when I’m at those testosterone levels.
I use a dab of emu oil &/or DMSO with my testim to smooth out the stickiness, spread it over larger skin areas and increase absorption.
@Art T
Something else you may want to consider for the fatigue, is having a sleep study done, and see if you need CPAP to compensate for sleep apnea. I was on TRT for over a year, and was enjoying several of the benefits, but still wanted my afternoon nap. Then last year I did the sleep study, and was prescribed a CPAP machine. The change was fantastic. I know sleep about 6-7 hours a night, and wake up wide awake, and don’t have the mid-day sleepiness. I also used to live on those 5 hour energy shots, and haven’t used them in months.
I noticed you mentioned weight, and if you’ve had a weight gain, that could be adding to your sleep problems.
I have been a user of TRT since 2004. I was 18 and diagnosed with hypogonadism. I have been on the shot, the patch, and the gel. The shot has a lot of ups and downs, and it gets worse depending on the infrequency of the shot. Lets say, 2 week shot. The first week your going to have crazy mood swings (anger, happiness, sadness) and the 2nd week your going to feel tired more and more until your next shot. You get used to it and begin to recognize why its happening and you can control it better. The patch is good if you have a sedentary lifestyle, but if your active its not good. The glue isnt very adhesive and will leave blotches at the application site for a couple of days after its removed. I never tried the treatment where you put a pill like item above your tooth and leave it there all day, I dont even know if that is still around. I have been on androgel packet and pump. I prefer the pump myself. I was on 6 pumps a day, 7 days a week for about 2 years, and my levels were at around 900. My doctor wanted them lower because she felt that it was a health concern to have it so high, so I was on 5 pumps a day, 7 days a week, but still had very high levels. Now I am doing 5 pumps tues,thurs, sat and sun and 4 pumps mon,wed,friday. My sex drive is a little bit lower but I feel normal for the most part. Side effects now, almost none. No mood swings, sex when my wife or I wants to do it, and I think my penis size has increased being on the medication. However, I did not go through puberty correctly, and I grew about 4 inches to 6 inches vertically and I did experience some penis growth. For anyone else out there that is young, teens to 30s or 40s, you should freeze your sperm before you start treatment because you will become sterile. As I was told, you also will never be able to get off the medicene becaues your body will cease to make testosterone. Also, talking to a therapist can be very helpful because starting a life long treatment that you cant get off of is hard to deal with. Find a great endocrinologist, dont settle for one that your primary physician may know. They may be buddies and he could not be up to date with the most current info, I experienced that. I am now body building with my brother, and have lost 50lbs in the last year as well, weight gain is very easy when you first start as well because your hunger can/will increase so control yourself. Post if you have any questions for a 7 year user.
chris,
i have been on and off of trt since august 11 2010 i was diagnosed with kleinfelters syndrome back in early 2009 , i was 19 at the time now 21,when i went for a physical to join the airforce. im not so sure i agree with your comment about freezing your sperm or at least i dont want to believe it, however recently i havent been taking my androgel regularly because it is too expensive at 300$ a month. is there any way to not pay that amount if so how much do you pay? also do you think its worth switching to testim advs / disadvs? i do no that being on trt does reduce the size of your testicles and because your body is not naturally producing the hormone you can increase your chances of becoming infertile . im also a regular smoker and drinker so that probably doesnt help either but from my last tests back in jan this year i did see that my levels rose to about 700 but i have no idea what they are now.
Jermaine,
Taking testosterone can cause you to be infertile, but lots of people still manage to have children after going on TRT. They will come off testosterone for a few months and take HCG instead, which brings back your testicular function and, sometimes, fertility.
As for price, you should check out a compounding pharmacy. There are plenty around, especially in Florida. Check out some of the bodybuilding forums but just make sure you’re working with a compounding pharmacy in the United States. Alternatively, you could look into generic brands. Or move to Canada.
Hi Guys, I am just around the corner from 65. For years I have been on meds to control high BP and lipids. I had heart surgery just after my 59th Birthday and recently decided to append my diet and exercise routine with TRT. My initial total T was around 400, which my doctor said was okay for my age. I started on TRT believing it would help with my energy level and aid in recuperation from two major surgeries late last year.
My initial effort was with Androgel and for some reason I stopped some months back; neither my doctor nor I can remember why. What I did not do was have my testosterone levels checked while on Androgel. I restarted TRT with the patch and my total and free levels (after two months) rose to the upper 1/3 for my age. During this period, I did quite a bit of research and discussed much of what I found with my doctor. We have been working to find ways to eliminate as much of my medications as possible while keeping my cholesterol levels on target as there is sufficient documentation to show that low testosterone contributes to CAD, high BP, loss of lean muscle mass, increase in fat and drops in calcium and certain vitamins.
We shifted to Testim to determine its efficacy on me. Two months after shifting from Androderm (patch) to Testim (gel) my free testosterone has jumped from ~11pg/ml to ~40pg/ml and serum testosterone from ~750ng/dl to ~1400ng/dl. While some may be concerned about the current levels, I opted for continuing my current regime and another blood test, then a conference with my doctor. I had blood taken last week and will discuss the results with my doctor tomorrow.
During my Testim trials, I did more research and conferred with my doctor; we agreed on best levels of free in the range ~21pg/ml to ~26pg/ml and serum ranging from ~750ng/dl to ~950ng/dl. These levels fall in the upper one-third range for 29 year old males and by my research are recommended for healthy males irrespective of age. For now my target will be to get to the free range then see where the serum falls out and go from there.
At this point my suggestion should anyone be considering testosterone replacement therapy (TRT)…go for it and be advised it may take six months to a year to find what works. Secondly, PSA levels should be taken annually as well as a digital exam at the annual physical to monitor for an enlarged prostate. No, I do not subscribe to the notion that TRT causes an enlarged prostate or contributes to prostate cancer, but without conclusive data (rather than suggestive) a bit of monitoring never hurts.
Understand that it is not just testosterone that drops as we age, but some essential vitamins as well. Along with TRT, I have included vitamin d, vitamin b12 and fish oil for omega 3.
I have more energy, sleep better and am more alert through the day. No, I cannot conclusively say I feel as I did when I was 25, but I certainly feel good at almost 65.
I’ll post again after seeing my doctor.
Studies have shown that the absorption of testim is slightly better than androgel. Yes it is easier to get androgel approved. testim is working on streamlining approval. Now there is axiron, placed under the underarm, decreases chance of transference, possibly absorb better in the underarm and is much cheaper, a tleast for the first year as the company is trying to break into the market. Overall I have been disappointed with the results of topicals and have switched many of my patients to injections and many to pellets.
It has been a few weeks since my initial posting and I have again met with my doctor. It is important to note that this is my general physician and not an endocrinologist. We tend to be conservative in our approach to my health; therefore the realization of my goal will take a bit longer.
The “off the chart” results were measured against a suspect range and therefore we discarded them especially after the follow-on test results using Testim showed me at mid-range, which is below where I want to be. As a result we shifted back to Androgel and increased the application to 7.5mg, which we shall test in October.
Commenting on Dr. Bellman’s post, personally I am not considering injections as testosterone levels tend to drop and rise from injection to injection. I have been diagnosed and treated for chronic depression, which is now manageable and a cycling of my testosterone would not be good. This is the first I have heard of subcutaneous pellets and will give this option serious consideration. My doctor has suggested consulting with an endocrinologist, which will be my next step if the topical applications do not sufficiently boost my free and total testosterone to the target levels.
I think this approach is fine. I must say having been doing this for years, treating hundreds and thousands of men I have been underwhelmed with the results with topicals. Injections can cause peaks and valley and I have many younger men inject twice a week that smooths out the peaks and valleys. I think it is appropriate to follow the advice of your primary doctor and endocrinologist. I have just seen too many men spend months or years with gels with sub optimal results. Many men are diagnosed with depression and are not really depressed (I have no idea if this applies to you), but the presumed depression is base dupon low T.
My recommendation would be to pursue this but if a few months pass and results are modest consider another approach. Pellets are one approach to have smooth levels of T and are placed every 4 months.
Dr. thank you for responding. But if you want advertising I recommend you contact me to ask about rates. I have removed your links from the post.
I have been on TRT for about 4 1/2 months; initially injections every other week and AndroGel since the beginning of August. Initially, my lack of energy and low libido was thought to be a thyroid issue. My PA (with an endocrinology background) suggested the testosterone testing. My initial level was low 300s and after the injections, it jumped to 1400. The key thing I noticed was that I felt great for about 5 days following each injection, but the second week I fell back into the low energy. Since starting the gel 7 weeks ago, I have leveled off around 700 and my energy level is fairly constant. I am also sleeping through most of the night instead of waking up every few hours. i am 58 years old and lost my wife to cancer 2 1/2 years ago, so my sex life was non-existent since 2008. I have been dating a younger woman the past 10 months and the TRT effects are a welcome change!
Hey guys.
I am 34 years old and about 6 months ago i had some bloodwork done for headaches and sex drive drops. Bloodwork came back and my testosterone levels were in the 230’s. This is quite low for someone my age! I started off on AndroGel and was on it for a month, when i went to get a refill on my script my insurance said NO SIR… They said they would only cover Testim. So .. For the last 3-4 months ive been on Testim and right off the bat I could tell the smell was very strong and i feel like when i wash my hands afterwards im washing a ton of test down the drain. I am trying to figure out a way to get back on androgel through swapping insurance companies from my wifes to mine. Hopefully that will work! As far as results .. Ive noticed somewhat of an increase in sex drive and somewhat of a increase in the strength of my erections. Id like to try AndoGel for about 4 months to see the difference. Any thoughts or testimonies of one or the other? I am thinking of stepping up my dosage on my own … start using 2 tubes of Testim after shower instead of one….
Chip – try applying it with plastic baggies on your hands. Less will stick to them so you’ll get more on your application area, and won’t have to worry about washing your hands or getting the smell on your hands. If you don’t want to pay for baggies every day, or are concerned with the environmental aspect of using them every day you could just reuse plastic shopping bags (inside out because the ink will come off) which is pretty convenient.
I have been on TRT since I was 15, now 55.
I am 5’11” and weigh 190 lbs.
Have been taking injections for most of that time. My Endocrinologist tried me on androgel for six months with varying number of pumps per day. By the end of six months I was up to 12 pumps per day in order to attain acceptable T levels (around 500 ng/dL) anything less than 12 pumps per day caused me to feel like crap. 6 pumps of androgel were applied twice per day in order to even out the absorpsion and still I was having trouble sleeping as well as unstable blood suger and a noticable loss in muscle strength. This was also costing my medical plan over $350.00 per month.
After that period of time I went back on injections (Deletestryl – 200mg / mL). Cost of this drug in Canada is about $60.00 for an 8 week supply (per 5ml bottle). The dossage that puts me in the acceptable T range aprox. 550ng/dL is .6mL (120mg testosterone) per week. I have tried higher doses, under Docters supervision but we finally settled on this dossage. I have also tried injections every 2 weeks with less than satisfactory results.
Some years ago, I was tought to do my own injections, which is almost neccesary if you intend to take this drug every week. I inject in my thighs (left thigh one week then right thigh next week). As I have been doing my own injections for over 20 years I can assure anyone out there that you will not enen notice youve done an injection after a while. Since I am the one doing the injection, I have leared which areas on my thighs are the best. Beleive it or not, there are certain areas which can be injected with ZERO Pian!
My experiance after 40 years of TRT is this:
* Injections if taken at the coorect interval will give a far more constant testosterone level than androgel.
* You must have regular blood tests to ensure that your hemoglobin dosent get to high.
* Sexual function is much better with injections.
* I have noticed that interpersonal abbillities seem to diminish with lower T levels. Those of you who are married may notice more trouble interacting with your wife at lower T levels.
* If you are on TRT and having trouble getting to sleep or staying asleep, you probably have low testosterone.
* Too much testosterone can cause sleep apnia and or a feeling of always being tired.
* Too little testosterone may case you to gain weight and or loose muscle mass.
* As I have an underying heart conditon which causes a small amount of atrial fibrillation, I have noticed that If I decrease the dossage by as little as 0.1mL Deletestryl (20 mg testosterone per week decrease) the condition becomes worse. Something I have discussed with my docter. That having been said, I have been able to do competitive sports as long as I maintain the correct T levels for my body size.
I hope this is useful to someone.
My testosterone dropped like a rock during a prolonged vitamin b12 deficincy that was unrecognized and untreated for decades. ALso a folate defieicny as I can onlyutilize the natural forms of b12 and natural methylfolate. This is a common effect og low methylb12. I started Androgel kin 2001. I noticed the difference within 24 hours.. However, with Androgel the level never got high enough to get erctions back. When the price of Androgel went through the celing my doc switched me to injections. Instead of hundreds of dollars per month my cost went down to under $25/month with injections. My doc started me at 10 day intervals but the last 2-3 days I was going down hill fast. With injections each 7 days of 140mg my serum holds level enough not to be able to feel the difference. At a dose less than 120mg/week I lose erections. I found that the injections were better at restoring erectile function than Androgel. My inrternist is happy with my serum levels. Used along with mMetafolin, methylb12 and adenosylb12 my depression is gone, I have lots of energy and rebuilt severely atrophied muscles to normal in 4 years.
Since my last post I have had my first visit to an endocrinologist and am scheduled to return in a couple weeks. I have been on 7.5 mg of Androgel for several weeks now and in general feel quite good. Blood test results from my recent physical show excellent for my age (65).
I have CAD and my GP and I are focused on triglycerides (72), HDL (42) and LDL (64). This is important in one aspect as articles on blood profile state with a drop in testosterone these values and others often go out of tolerance offering an opportunity for many diseases. We are not specifically treating me for ED, that has yet to become a significant problem, but treatment is more focused on overall health.
No, we did not do testosterone, but the endocrinologist did and when the results are known I will post them here. For those of you who are using implants it is probably reasonable to note I live in the DC metro area and thus far have found only one doctor who does implants. He speaks positively of them, but my GP and I are not fully sold. In speaking with my GP and endocrinologist I have expressed a wish to adjust any treatment for low testosterone so I fall as close to the upper 1/4 or 1/3 of a 30 year old male (total 850-1100 and free 25-31). While these ranges are reasonable and laudable they may not be achievable.
I found the site because new insurance rejects Androgel Rx over Testim… so looks like I will be switching. (Testim cost is on-tenth of the Androgel … not sure if I’m comparing like dosage)
Wanted to respond to Testopel idea. I had used pellets for years, until my gynecologist retired. The pro’s were no risk of transference (wife and young kids), convenience — well, 50 mine trip to OB-GYN every 3-4 mos … versus daily application of goo :), both seemed to provide a consistent level of T based on stamina, mood, etc.
I am a 2x survivor of testicular cancer- resulting in hypogonadism. I’ve used patch, androgel, testopel. Have not used Striant (just a pinch between your cheek and gum LOL) nor injections.
Began HRT in 1997. -tb
Met with the endocrinologist and my results for 7.5 mg of Androgel are 843 total and 17.3 free. While these are good, it is my belief they could and should be higher. We agreed to up the daily dose to 10 mg and return in three months after more lab work. The results should be a good benchmark for topical application of either Testim or Androgel.
Let me take a moment and discuss my thoughts on both topicals I have used. While there is a notion floating about that Testim is absorbed quicker than Androgel, it is probably no more than 1-2 hours difference. So if the topical is applied at 6AM, Testim may possibly be absorbed by 7AM and Androgel by 8AM or as late as 9AM. The difference in quantity absorbed into the blood for 5 mg of either is probably negiglible (I have not seen documentation that reports differently). My preference is to Androgel for two reasons, the lack of both strong smell and tackiness of Testim. What I have also changed is where I apply the Androgel. I was applying to both shoulders as well as abdomen. My abdomen is covered in “guy fur” which got me to thinking much of what was applying to my abdomen was ending up on my hair rather than skin.
I will report out in February the results of my latest blood work and if I decide to try Testopel. The implants are a bit of a draw for me for convenience more than anything while they should also provide a consistent level of testosterone through the day. As you know testosterone is naturally produced at night and at its peak in the morning, which is why testosterone lab work should be done just a few hours after topicals are applied.
I have spoken to Androderm and after using it for three months and personally believe the nuisance factor is high, too high for me. While that may be true for me it may be a good fit for others, so to those TRT newbies, try them all.
Is it my imagination or has the formula for Testim been changed to reduce its odor? Also, to avoid wasting so much on my hands, I simply apply a pair of latex surgical style gloves before applying Testim. I liked Androgel better, but United switched to Testim for coverage. I’ll have a blood test in a few weeks to see if it works any differently.
I switched from Androgel 1% to Testim 1% because of the cost. My insurance provider (UnitedHealthcare) prefers it over Androgel, but I’m having second thoughts.
1. The Testim gel does not apply well or dry as quickly as Androgel. My t-shirt sticks to the gel most of the morning.
2. Having to smell Testim all day is not my favorite. There was no smell with Androgel.
3. The Testim tube does not dispense all of the gel content. It is very difficult to remove ALL of the gel due to the design and thickness of the tube. Androgel’s packet made it easy to extract all of the gel with no hassle.
4. The first time I tried Testim it made me hyper. It was a strange feeling. Also noticed an itching sensation near my testicles.
My greatest concern is hair loss. I’ve heard reports that using Testim can increase hair loss. I did not notice any hair loss from Andorgel over several years of use. Can anyone confirm this statement? I’ve been losing eyebrow hair over the years, but that may be due to my hypothyrodism.
Hello Tony,
Hair loss is the least of my concerns when it comes to taking lifelong medication, but I can see where you’re coming from. In terms of Androgel Vs. Testim, I doubt it matters. People say Testim causes hairloss because it has to be applied to the skin and the skin has more DHT receptors. If that’s the case, Androgel would be just as bad.
My advice to anyone who will be taking this for the rest of their lives is to do a weekly injection, but of course this is something you’ll want to discuss with an endocrinologist. Don’t just go with a family practitioner because the endocrine system is extremely complex.
Good luck!
With topical testosterone there is theroreticaly a higher risk of hairloss as the skin produces more DHT (dihydrotestosterone) which leads to prostate enlargement and baldness.
Propecia blocks this conversion. Injectable testosterone or testosterone pellets have slightly less chance of the baldness and are also generally less expensive and more effective.
topical vs injections vs pellets?
what sort of doctor to see?
all good questions….
There used to be only androgel, then testim came along and was reported to be more effective, then fortesa and more recently axiron which is placed in the underarm.
I have prescribed thousands of prescriptions for these topical products and have for the most part stopped as they are inferior to injections and more costly, messy and the risk of transference to partners.
Injections are effective but need to be given weekly; now most of my patients are getting pellet insertion which is good for 3 months and takes 4 minutes to insert.
16 injections vs 1 insertion, seems to make sense.
What sort of doctor should you see for testosterone replacement?
The answer is one that is interested and knowledgeable about the subject as well as the potential side effects.
I’ve been taking Testim for 2 months. I searched Androgel vs Testim because my insurance company changed policy, needed a “peer-to-peer” discussion with my doctor, then rejected his reasoning for prescribing Testim, and want me to take Androgel. Why is this different than other posts, where that is reversed? What gives with these insurance companies?!
Fred- –
I also had a B12 deficincy along with Testosterone def. with my bloodwork, but I had no idea the two could be related. I’m glad you brought that up so i can do a little more research on the link between the two. Thanks for sharing that.
I started on Androgel in 2007 for Low-t, i was in 200? range and was 38 years old. Suffering from depression, low energy and lack of desire for most things. Weirdly my sex drive was fine. I lost weight, felt better general improvement. Levels rose to upper 400’s. My Insurance company switched me to Testim last year. I held out until 2 months ago when I ran out of Androgel, I will worse again, very depressed (severely). I dont think the testim is working or have I become Used to it? I am going to schedule a visit with dr soon to check levels and discuss options. Problem is I moved so I have to find a new dr, new insurance and hopefully they will be versed on treating Low-T.
I have been on replacement therapy for a long time. I took Androgel for a long time, until my insurance company required the change to Testim. I liked the Androgel pump more, because of the convenience and the non sticky applications. Testim has seemed to be a more effective product for me. It may just be other factors, as they do seem to be clinically identical. I have liked being on these products for the more youthful body, muscle increase, and a libido that stronger than I have ever had. I have developed chest hair that I ddi not have before, I also believe that my penis is larger that it was. erections last a long time, and sex is on my mind constantly. I am not some wild Valentino, but I like how I feel. My wife has noticed, and does not have the same desire for sex, but appreciates the continued sexual attraction. Masturbation is necessary (not a bad thing) as I must have sexual release often. I am nearly 66, but am told that I pass easily for 50. genes are of course a factor, but I know that this hormone treatment is keeping me younger.
I have been under the care of an endocrinologist for six months and during this time, as well as six months prior, I have used various topical products with similar results. At 65, it remains my contention that my t-levels should, for various sound medical reasons, be near those of a 28-30 year-old healthy male.
When I started TRT my total-t was 350-400, which was an acceptable level on the standard age-related scale. Today, my total-t is 600-650; closer to my goal of 800-850, but not on the mark. Next month I will start on implants, with reasonable assurance that goal is achievable.
More after my next round of bloodwork.
Hi Chip,
If caught early enough on the downwards slide, methylb12 secifically Jarrow or Enzymatic Therapy B12 infusion are the two by far superior brands and some guy recover testtoterone without having to go to testosterone therapy.
dr.b, who makes the pellet?
Hi guys. I am a41 year old and just started taking Testim 6 days ago. I am an athlete and work out very hard at the gym. Aside from my low sex drive, I am hoping that this gel helps me in my training. Have any of you experienced muscle growth from using testim? I am currently on 5mg a day. I have been using a latex glove to apply and find this great.
first of all please don’t waste your money nor your hopes on any natural testosterone remedy, it simply doesn’t exist.
For best results put the gels(testim, androgel, axiron, fortesa) aside and consider injections or pellet.
I have switched most of my testosterone patients from topicals to injections and now to pellets.
The pellets are placed once every 3 months; very effective and convienient.
you can check out an insertion on youtube put in gburomd and you should find my video
Hi Ron,
If the low testosterone comes from functionally low b12 then certain nutrients, specifically adenosylb12 (dibencozide), methylb12, Metafolin, l-carnitine fumarate and a good base of vitamins and minerals will help build mucles at a very good pace.
I dont know how many of you are on testim, but I am. I was androgel for about 4 years with no side effects. Change of insurance, United Healthcare only covers testim, however, after 2 months of use im starting to breakout from a rash on my arms and stomach. Found out after talking to insurance company, that my doctor has to submit an appeal to the insurance company to try and get me onto another medication. If any of you have the same problem, its part of the inactive ingredients, and you may be able to follow the same process to change medicines.
Chris, I didn’t get rashes but I got big pimples (actually more like small boils) on my chest where I applied the Testim gel.
O.K so now I have been on test get 5mg for 2 weeks now. My erections hurt. Is this normal? I have also lost an inch or 2 from my belly, is this one of the side effects? Thanks guys for all the information. I am getting my blood work done tomorrow and if I still need to take the test, I think I will move from the gel to the injection if my doc agrees. You guys are right, I have not recognized any advantage in the gym. I am having a few sleepless nights though. Any advice would be great. Thanks in advance. Ron
Testim can be quite irritating to the skin; the perfumey scent that it has is from a chemical that helps absorption and many can experience an allergic type reaction with tiny red bumps….
Ron,
Maybe you need a slightly lower dose, or skip one day out of 4 etc. This may not be a bad thing after all, erections that strong and hard (I assume they is what is happening)may jus take some time for your penis to adjust, and possibly gelt larger just as some of the penis lengthening products are supposed to work. But, if the pain is intolerable, get help.
Hey guys, I am getting the rash on my arms as well. I was using the gel testim for about 6 weeks.My t count actually decreased. Just came back from the doctor and I am now on injections once a month. My doc prescribed Delatestryl. He put me on 200mg every 4 weeks. Any of you have experience with this?
Ron, Delatestryl is just a brand name for testosterone enanthate. It is what I would recommend. I take testosterone cypionate, but that’s because my insurance wouldn’t cover enanthate for some reason. Ether way, with weekly injections it’s about as stable as you’re going to get. Congrats on moving on to injections. You’re going to feel much better soon!
I am currently on Androgel and will be having implants this week. Does anyone know if tapering off Androgel is necessary? If so what is the suggested plan?
Navybill hopefully someone with a medical background will reply, but if not I can at least offer my personal experience. No, I don’t think tapering is necessary with Androgel. The gels seem to have a pretty sort half-life.
Hey TRTMan. thanks so much. I had my first injection on Thursday and now 4 days later, I do notice the difference. I am so happy that I do not have to use the jell anymore. I am 41, and still cant believe that this has happened to me. I am happy that this forum exists because it is the only place where I can get some factual info from men having the same issues. The one good thing is, I have a six pack again…lol.
Well, I went to a new doc 2 weeks ago (moved to a new city). I wanted to try Axiron. I have been Testosterone Replacement for over 5 years (Androgel 4 years, Testim 1). Hated Testim, too thick, didnt seem to absorb the same as Androgel. Insurance made me switch. Axiron has the free trial cost. The doc ended up being a whack job, who admitted he was himself “Juicy” over the limits with Testosterone Replacements. But, got my script anyway. I am really liking the Axiron so far. Easy delivery without touching it. Important to me (my 36 YO GF is pregnant). Always worried about other types no matter how much I washed my hands. I seem to have energy coming back strong. I will keep you updated as I go.
Jim C good to hear you’re moving forward. Good luck to you! Personally I prefer injections over the gels. It’s a literal pain in the ass once a week Vs a metaphorical pain in the ass every day.
This is not real important, but I just want to know why it is so important to limit where you apply Androgel. Why are the specifics not shown anywhere? Do not apply to penis or testicals, I don’t and I won’t, but why? In the time I have used Androgel, I have found it difficult to have enough space to apply a full dose in the limited area shown. So, I have applied to my lower legs, always on my chest, upper arms, at times to the lower arms, armpits, and occasionally to my ass. I don’t seem to have any problems with this.
Guys, so |I have been on test now for about 6weeks now. My penis, when hard has gotten allot thicker in the middle but not at the base. Have any of you experienced such a thing. This replacement therapy sure does take some getting used to. I had my first injection almost 2 weeks ago. Any info would help. My doc is away for 2 weeks.
I have never noticed a change in penis size from testosterone. But I do start to develop a little bit of Peyronie’s disease (look it up) if I stop taking it because I could go weeks without an erection, which I think causes scar tissue to either develop or become less elastic.
Over the course of the past couple of years I have researched TRT methods and values for total and free testosterone. Current thinking suggests testosterone dropping as we age is natural and just fine. I suspect this is due to the fact that the medical profession has not done adequate research and may not be well compensated for treating low testosterone. On researching age related values I can only conclude that the age related scales were derived from what happens vs what should be. Personally, at 65 I do not see why my testosterone level should not be somewhat near that of a 30 year old male with ‘normal’ levels. After trying patches and gels I have settled on implants in my goal to achieve a total testosterone level near 1000 ng/dl. Implanting, while not pain free, is not a difficult procedure. My doctor implanted 12 pellets five days ago and I return at the three week mark for blood work and see my doctor a week later for the results. We will discuss if adjustment is necessary. It is not my goal to be a virile 30-year old again that will just not happen. If you read my posts above you will get a sense of what I feel is important and my goals for overall health. Of course a healthy and full sex life is a plus all the time.
I too went from patches (I hated them) eventually got the Androgel pumps, easy and good. Then insurance said no, you need to be on Testim, the little tubes. Now on Medicare I am back to Androgel packets. I have to go in and see if I can get a safe increase, I have been between 350-500 total testosterone. I want more, I like the way I feel and look. Possible change in size of penis, but it may be that I am paying more attention to it. I too want to feel more like a 30 year old, and why not. I may need a second wife for sex, as mine is not very interested.
I had multiple tests done on my blood (thyroid, Pituitary, ect…) and everything seems to be in order. I originally tested at 400, had 10 pellets inserted 2.5 months ago, but was very disappointed that my levels only got to 500. I would like to get in the 800+ range as I still seem to have the effects of low T, however my Urologist says I have to wait to wait until these are dissolved (4 months). Should I be seeing a Endocrinologist for TRT rather than a Urologist?
Mike,
See an endocrinolgoist.
The common question a urologist vs an endocrinologist????
you should see someone who is interested and knowledgeable about t replacement.
I am a urologist and get referrals from my endocrinologist colleagues.
I place alot of pellets and they work great. 10 is usually not enough for many men who need up to 16 to maintain levels of 800-900
when you choose a doctor see is t replacement is a big part of his/her practice
see if they prescribe arimidex, HCG and clomid…if they don’t look elsewhere
Dr Bellman
Hi
is there any body who is on TRT as a result of 5 alpha ruductase inhibitor use. I mean finasteride or saw palmetto extract.
I have seen the trend that if you got low T because you messed with finasteride or saw palmetto then any TRT ( gel or injection) does not work
and another thing do you guys use any aromatase inhibitro as well with your gel or injections?
thanks
Hi guys. So its been awhile now and my test levels are all over the place. My doctor put me on 200mg every four weeks and my levels still did not increase. Now I am on 300mg every 3 weeks. I still get erections that are painful for a few days after my injections. It is really frustrating. I hope we get this under control soon. My doctor did not send me to an endocrinologist. Is this necessary? I have read other posts stating about tumors on the pituitary. Any of you concerned about this?
Ron,
Switch doctors. This one doesn’t know what he’s doing. Go see an endocrinologist.
The pituitary tumor is pretty rare. I’m not sure how old you are, but if you’re over 35 it’s probably just early andropause. Still, it is always worth finding out what the problem is IF you can.
200mg every four weeks is just a silly dose and schedule. And 300mg every three weeks is better, dose-wise, but the frequency of injections is still too far apart? Does he let the insurance company dictate your health or something? I’m not a doctor, but from my experience and from what I’ve read from others on this blog, about 75mg per week is what many of us take for an ongoing dose and we take the injection EVERY WEEK. I feel best on 100mg per week, but over time that builds up and I start noticing a little high BP and high red blood cell count. When I weight the risk factors, cost, health, etc… I think about 75mg taken every week works best for me for life-long TRT.
Everyone is different, but few seem to have a good experience at injection frequencies further apart than two weeks. If you go with ever two weeks instead of every week you’ll still get there, but it will take a little longer for the levels to stabilize. So you may feel like you’re on a bit of a roller coaster for the last few days between injections for the first few months.
Good luck!
My Doc has me on 140mg/7 days or 20mg/day for other than 7 day intervals. I have been injecting at this level for 8 years or so now and have been quirte stable with no side effects.
Tony,
I have been the underarm version (Axiron) for about 2 months. I have noticed a steady stream of my hair in the bathroom every since. Most of the hair seems to be coming from the back of my head. Do a Google search and you will find plenty of reports of guys developing bald spots after about a year of treatment.
After only 2 months TRT has already fixed so many of my problems-mental and physical that there is no way I would every want to go back to my old self to avoid baldness. That can be fixed if it really bothers you.
A month ago I had Testopiel pellets implanted and the results show my free at 679 which is consistent with what it measured using Testim and Androgel. In speaking with the endocrinologist my desire is to target near 1000; he is confident this level is attainable. More later.
I am 31, 5’7, about 175-180lbs and was diagnosed with Hyperthyroidism just over a year ago and have been taking meds for anxiety and recently got on meds for depression. I have been working out with a trainer 5 days a week since January 2012, and haven’t lost ANY fat even after following a strict and healthy diet all year. I asked my PCP to test my T levels and they came back at 195 – super low for a guy my age. She said she also tested my pituitary gland function and that the results came back normal. Started me on 50mg of Testim 1%/day. It’s my 4th day. The smell doesn’t bother me, I actually like it. I have felt like I am washing a bunch of test down the drain when I wash my hands. I hope to start feeling better by the end of the month (June), and will have my levels checked come July to see if they risen from 195… I sure hope this stuff works!!!
Jeff,
195 is indeed low for someone your age. It sounds like you and I have some similar problems. I had my thyroid removed and am on thyroid meds for life too. My testosterone levels were about where yours were when I was 31. I’m 35 now and my levels stay between 600-1,100 now, usually around the 800 range is where I like to be. I didn’t find that the gel kept me there consistently enough so I started doing injections weekly, which works for me. As long as you feel better, don’t get any sides you can’t deal with and it isn’t too much of a hassle just stick to whatever works for you. Good luck!
TRT man- thanks for the reply. I didn’t have my thyroid removed or burned out bc my Endo said my levels were borderline hyperthyroid. I called my PCP and asked for injections and she prescribed me Testosterone Cypionate 200mg/meve try two weeks. I took my first shot on Monday and am going to continue using Testim every other day to see where that gets my levels in the next couple months. I read a bunch of the threads above and believe it or not I had THREE females at my office all ask what cologne I was wearing. They were all gathered in the same office so it’s not like I had 3 girls asking me in separate circumstances… Pretty funny. I told them what it really was and we all got a chuckle out of it.
Thanks again for the reply man; I’ll repost in a month or two once I have my levels checked again… Hope to be above 400 range by then!
God bless,
Jeff
TRT man – Thanks for the reply. I actually asked my PCP to switch to Cypionate and she had no problem with that. Got my 1st injection on Monday of 200mg\mL, but she only wants to do it twice a month. The half life is only 12 days max on Cyp, so I called and requested to do weekly injections. THey didn’t budge, so I went to the “Low T Center” today. They said I was totally correct and that weekly injections are a must for TRT. They took blood there and had results in 15 minutes. I was sub-200 Monday when I got the first injection and measured at 595 today. I asked if that big of a jump was normal and he said yes, and that he thought I would of tested a little higher. So, I am having my records transferred from my PCP to the Low T Center and go back Monday to start weekly injections! I’m guessing it will be somewhere between 100mg-200mg/mL weekly. I’m not really feeling any increase in sex drive or energy lately, but I do feel a little better when I’m in the gym and have had a couple great work outs this week. I’m bummed b/c I actually got a few compliments on the smell of Testim! I read a few threads that said chicks dig the smell while some hate it. I got good feedback and we all got a good chuckle when I told them it wasn’t cologne.
Best of luck with everyone’s health and God Bless,
Jeff
Plano, TX
I’m a 56 yr old male and have been on TRT since 01/10. I started with Androgel given by the Internist after I complained about fatigue and loss of sex drive. Blood tests showed my T was low but not terribly low. Androgel has it’s upside as has been pointed out. First it is not sticky and does not smell. It’s very easy to apply and you don’t have to mess with the metal tubes of Testim. I had no side effects with Androgel. As a matter of fact I had started to have slight symptoms of BPH prior to starting the Androgel and they went away totally after I started the the TRT. Even though my prostate is mildly enlarged when I started my PSAs have been fine and have not had elevated PSAs with TRT all these years. My blood work is good and no problems in blood levels at all. United Healthcare which others have pointed out removed Androgel and will now only pay for Testim this past year so I had to switch to Testim after using Androgel for two years.
I started using Testim in 05/12 and I can say yes it is sticky and the tubes are a pain to work with. You can not leave it on your hands at all because the stickiness is too much even when it dries. Yes it does have a smell and some women do like it, asking me what’s that cologne your wearing? People who are hypersensitive to smells will detect it on you as well.
The smell doesn’t bother me but people who are aware of it may detect it.
Now for the comparison of the two for me:
I have noticed that the Testim works better than the Androgel did in terms of sexual effects and mood for me. Since I did start to work out during the start of TRT ,the effects on muscle tone have been good as well as fat on the body. I must say that you need to give it time before you change dosage. Testim seems to be working better and my doctor did say I could get injections if i wanted it instead but I declined. My T level was 249 in 5/12 when tested last but that was before I switched to Testim.
You have see which works better for you and your body chemistry.
A few months ago, I asked my doctor to give me the new 1.62 Androgel. It is easier to use, as less is needed. I find that when I use three pumps instead of the two that is prescribed, I am more hound like. I feel stronger desire and interest. I can’t do this regularly, as I will run out too early each month. I will talk to my doctor, but I believe he feels someone my age should not expect much or need much. He is wrong about that. Even if it is most me and my hand, I want that strong desire and feeling. My blood test results are at 445, out of what they call a standard range of 241-827. Last time the total was 380. I want it to be higher, but my doctor says my results are good. I want to balance the highest total testosterone I can get with the lowest risk of prostate problems. I do not know if I am there.
The other thing that I need to know is why I am told to only apply the gel to my upper arms. I find that I need to put some of it on my chest and or sides, to use it up. Why would this be a problem. Who knows if there is a real concern if it is applied elsewhere? No, I do not ever apply it to my penis or scrotum areas.
Testim is working well for me. For those of you dealing with stickiness when applying it, do what I read elsewhere and which works for me: Lay a plastic sandwich bag on the counter and squeeze as much out of the tube as you can onto the bag. Roll up the rest of the tube, then squeeze the remaining gel out with a pliers. You will get up to 25% more gel that way. Then put your hand into the bag and use it to rub the gel on your chest. There will be very little on the bag when done (no waste). Lay the bag out and use it the next day. Any gel still there will dry out and will mix with the next day’s gel. So you really will waste nothing.
I am waiting for a reply from my doctor regarding why my level has dropped so much. I have been taking the 1.62 Androgel for about 3 months and the recent blood test showed 295, my highest reading since starting TRT several years ago was 533. Nothing I can see has changed, except the Androgel type I am using. ON my own I have increased from 2 to 3 pumps a day and know I will run out if not increased. Has anyone had this issue?
Lots of people have reported drops after long-term use of gels. I prefer injections for that reason, as well as many others.
Dear Gel users,
Wake up and get off the gels!
They are all a waste of your time money and effort and will not achieve good levels.
Just because they package things differently and say it is stronger doesn’t mean it is better.
I have been doing t replacement for the past many years and prescribed many gels and don’t believe they are effective and is some cases actually lower one’s levels.
Injections or pellets are simply the way to go
Dr Gary Bellman
I started on Testim and switched to weekly injections. I jumped from 190 to 762 after the first injection (100mg cyp), and have been doing weekly injections of the same dose. Just had my
Blood results come back and my levels were around 545; a little lower than I’d hoped for. My estradiol was around 35 I think after 3 injections, so now I take .5mg of Arimidex every 5 days, and it’s cut my estradiol down to 15! If you can do the injections you’ll start feeling better faster and your levels should be more consistent!
Best of luck to all!
I started my testosterone therapy journey 2 years ago. At 40 yrs old I went to my family doc for a routine physical (hadn’t had one in 10 yrs). I had definitely noticed a decreased libido, more bellyfat and love handles, and restless sleep happening over the prior few years. She tested my total & free test levels….total was 250 & free was 6.5. She declared that I was normal and refused to start TRT but encouraged me to seek out someone to help if I chose. I found a knowledgable Internal Med doc who agreed to help. Our goal was to get levels to the “high” end of normal while keeping BP, bloodwork, and prostate healthy. I initially was put on test cyp injections…100 mg every week and .5 mg of Arimidex twice weekly. Felt good and 6 mos later my free levels were in the low 400’s & bloodwork was good. We decided to go to 160 mg by trying 80 mg every 4 days. Definitely got a boost out of that but felt like a human pin cushion! 6 mo later and levels were 525-ish and 11-ish for free. Better but not to our goal. Went to 200 mg every 8 days. I really liked this dose but could feel the drop-off after about 4 or 5 days. Also, BP jumped a bit at this dose and red cell count went a couple points north of high normal…PSA & prostate were still good….levels at this dose were low 600’s and 13-ish. About 4 months ago my rear end needed a break from injections so I went to Androgel 1.62%…3 pumps per day. Definitely not as powerful as the injections but a nice break. I’m due for some labwork here in the next couple of weeks so interested to see where my levels are after 3.5 months on gel. In 2 years I’ve lost 25 lbs of fat (I strength train 4 days per week & cardio 2-3), my libido is very good…any hornier and I’d be worried I’d do something stupid (I’m married) so I need to keep that in check. I sleep a lot better and I have tons of energy throughout the day…can even come home from work and play all evening with the kids without getting tired. Point being…if you’re on the fence about doing it I say go for it….IF and that’s a big IF you can find an experienced physician who understands the intricacies of treating low T.
I have been on TRT for over 40 years, I am now 56, 5’11” and 200 lbs. I have used cypionate and enanthate as well as androgel. This comment is for docters as well as the people who are actually using these drugs. Cypionate is not a good chioce if you are having trouble obtaining normal T levels using 100mg per week. For some reason some of us respond MUCH BETTER to Enanthate.
In my case 100mg of cypionate per week causes verry unstable blood sugar. going to 150 or even 200mg per week showed no improvement. I have now been on enanthate for 20 years with a breef period on cypionate just recently. The difference between these two drugs is night and day. My present dose of enanthate varies slightly between 115 – 120mg per week (docter approved). My T levels are high end of normal, and I have STABLE blood sugar. I can also say that 9 – 10 pumps per day of Androgel 1% (docter approved) is a good equivelant to enanthate for periods of up to six mo.
Good luck all.
I used androgel for about a year before switching to injections. That was in 2000. The androgel was so-so but with the pump making it able to adjust dose better muight be better now. I find that I have to inject 140mg of Cypionate each 7 days. That keeps me very stable at high-normal. My dose is based on a tirration to effectiveness. Just a 10-15% lower dose and I no longer have normal erectile functioning. 10 days is too long and I go downhill substantially on day 9 and 10. I take a complete set of supplements daily including adb12, mb12, mfolate and GTF Chromium and have no sugar problems of any kind. I am currenty 6 feet all and 203 pounds with a 48 inch chest and 35 inch waist.
I AM AGE 71 – HAVE JUST STARTED ON 50 MG TESTIM- AFTER 2 WEEKS, NO CHANGE. I APPLY IT IN THE EVENING, NOT IN THE MORNING (WHAT’S WRONG WITH THAT) ALSO, INSTEAD OF GOING TO PELLETS OR SHOTS, HOW ABOUT AN INCREASE IN THE DOSAGE – HAS ANYONE HAD A DOSAGE INCREASE?
Well I was on testim for 3 months it worked great. Now insurance says I have to use the androgel, after 2 months my counts went from 500+ down to 200+. Now I’m going to try the patches. What I have experienced is severe Brain Fog, Mental confusion, weakness, severe depression etc. Has anyone else had this? Once I was on the Testim in 3 days things started to feel and get better. I was as low as 197 then.
Hi guys. So I have been on injections now for about 6 months, I get 1.25ml every 21 days and it has helped. The unfortunate thing that is happening is my testicles are shrinking and when I get an erection they seem to want to disappear under the base of my penis. Is there something that is on the market or something I can get from my doc to prevent my testicles from going small after every injection. Please help.
You can ask for human chorionic gonadotropin (hCG). It is injected like insulin into your stomach fat with a very small needle. It is nearly painless. But it does tend to mess with the balance of your testosterone levels and can raise estrogen if you’re not careful. And I’ve heard that it can lose effectiveness over time for reasons more in-depth than I want to go in a comment. I look at HCG as more of a short term thing to just remind your testicals that they’re still there, or if you’re trying to have, or plan on having, children. If you know for absolute sure you don’t want to have kids and you’re going to be on testosterone replacement for life my advice would be to get over it. Your balls will shrink. Good! Chics like a nice tight sack. Look on the bright side. You’ll never, ever get saggy old man balls. Your wife will be happy.
I take (2) shots per week. (1) 0.25cc on Thursday @0800, and (1) on Sunday @8pm-12pm. Thus, they are uniformly separates the week in two. I also use gel to smooth out the troughs, the lows, inbetween shots. For example, my shot on Sunday, kicks in on Tuesday AM to noon. Come Tuesday night, I take (1) squirt of Androgel pump. I take another squirt of gel Wednesday @0800, (1) at 4pm, and then one at 11pm, (total of 3 for Wednesday. I take 1 more gel squirt on Thursday, 8am, the time of my next shot. I repeat gel come Saturday 8am with (1) gel, and (1) gel at 8am, (1) at 2pm, (1) at 8pm. Sunday, (1) at 8am, one at 10-11pm, the time for my next shot. It works well to get rid of the lows. The graph of a T-cypionate is a Saw Tooth, like a Sinusodial/ sine wave. **The worst thing to do, is to take any gel when you are peaking with your shot. This has worked great for me. I have done this for the past two years and feel great. Sometimes, I will cut back slightly on my shot amount, to 0.24 or another day increase to 0.26 other times depending how I feel. I also do this with my gel. I never increase the amount of gel more than (6) squirts per shot. The amount needed of gel, or shot is dependent on the person. But, the basic theory, idea, is there- just, whatever you do, don’t take gel when you are peaking. Without using the additional gel, my Blood Pressure will go way too high when I am bottoming out with the shot. With the gel, my BP is 120/80 during my shot peak, and then when using the gel, it goes no more than 139/85. Without gel, it goes up to 170/90- not good. Of course, the reason I am looking at all the comments is that my company’s insurance company just cancelled Androgel and will now only allow Testim gel. The major problem with Testim **** It has NO PUMP! That is lousy. With a pump, you can take exact amounts. With Testim- they give you a 5gram ketchup pack. What the heck is with Testim not providing a pump?
Derek I hear you on the pump thing. Maybe a “testosterone gel pump” patent has been filed by the makers of Androgel or something. Thanks for sharing your experience. I’m glad I’m not the only one who unilaterally decides to dose up or down depending on what I “feel” like I need to be doing for myself at the time.
I’ve been on this journey like everyone here for years androgel, testim, shots, androgel,shots gel and now testim again. All of it is a pain in the back side. I didn’t like the shots. First I went every 2 weeks but the mood swings were terrible. Felt like I had PMS (or the equivalent). Then shots every week. Hated driving and waiting in the office waiting room to get shots. Went on gel, no good. Started giving myself shots, didn’t like that at all. I read this and it makes me smile because we all have been through the mess.
Yes, my muscle mass increase was incredible. Not sure why my muscle mass was so good because my levels never went much over 600. Any increase in penis size is a blessing and if the nuts shrivel away, so what. When I got 18 inch guns my balls didn’t matter and I’m in my 40’s.
I was wondering if anybody ever heard of the buccal delivery system. I figure throw something in your mouth and let it alone. No mess. Does it work? Can you kiss and pass it on to someone? I think it stays in your mouth all day. You Mac down with someone and their tongue is in your mouth??
Guess I’m asking if anybody tried it and if so, what do you think? Thank you. Happy holidays folks.
Just keep a pair of needle nosed pliers next to your box of testim. For what that stuff costs me, $347 for a 30 day supply until I reach my $5000 deductible, I want every drop. I squeeze out as much as I can by hand. Then I start at the bottom of the tube and use the nn pliers to squeeze out the rest , crushing flat the top of the tube. You get a good little bit out of there that you can not extract by hand. Easy as pie. Just wash the plastic grips of the needle nosed pliers when you wash your hands and dry them off so they don’t rust. I use needle nosed pliers because they have flat jaws. Works great.
A question I have is are you getting the maximum effect by using that whole tube on just your shoulders and upper arms? I am of normal build but it seems like I am putting 2 or 3 layers on top of each other by restricting the application to just those areas. Also, I am also more or less rubbing it on instead of rubbing it in. It would take forever to rub it all the way in. Is it necessary to rub it completely in?
Also, if you don’t like the gel on your hands, you can buy a box of 500 disposable gloves pretty cheap. They have the consistency of a Wal-Mart bag and are designed and approved for food handling. Cheaper and easier to put on than surgical gloves, you can’t beat the price. I just use my hands because testim is to expensive to throw away by leaving any on the gloves.
I am 61 and my T level was about 150 a year ago. I started on 2 pumps (40 mg.) of Androgel 1.62% per day and raised my T level to 300 and I felt a lot better – more energy, better libido and better mood. My doctor let me try 3 pumps (60 mg.) per day to see if I would feel even better, but I haven’t noticed any significant improvement over 2 pumps. I am interested to see what my T level is with 3 pumps.
I am going to ask my doctor about going back to 2 pumps to save money. However, my insurance company recently stopped approving Androgel, but they will approve Testim and Androderm so I expect my doctor will prescribe Testim for me.
A bottle of Androgel 1.62% lasted 20 days (3 pumps per day) or 30 days (2 pumps per day) and had originally cost me $260. with insurance and Androgel’s restoration program savings card. In the last few months Androgel has cost me $300. with insurance and Androgel’s restoration program savings card. It would cost me $470 a bottle without insurance.
I tried Striant a few years ago, but I did not notice near as much improvement as with Androgel. It was sometimes a hassle keeping Striant stuck to my gums and my dentist thought it might have promoted bacterial growth in my mouth resulting in an increase in tooth decay and gum problems.
It turns out that while my medical insurance stopped paying for Androgel, apparently Abbott Labs – the maker of Androgel – picked up the difference so I am still using Androgel and paying $300 per bottle for a while anyway. My Androgel card says “Pay as little as $10 per month for up to 12 transactions (original bottle plus 11 refills), a savings of up to $50 per month.” Maybe a person has to have really good insurance to pay that little. Confusing.
Now for something completely different…..
OK, I’m an academic endocrinologist who treats many men for hypogonadism (and am hypogonadal myself), so let me just offer my perspective (which is different than most of yours).
First, there is no treatment that is best for all patients, and I see a role for testosterone injection, patch, gels, and sprays. I see my role as accurately and clearly relating the pros and cons of all available therapies and helping the patient choose the therapy.
Having said that, I tend to prefer transdermal over injections, mostly for better PK (e.g., sustained levels that follow the normal diurnal variation of testosterone when applied in the AM) as opposed to supraphysiological levels for awhile followed by sub-optimal levels for awhile. Which is not to say that some men don’t do well on injections (some do), or that injections aren’t a lot less expensive for someone without good insurance (they are). Just that I don’t believe that injections are necessarily optimal for most hypogonadal men. Further (and this is not directed at Dr. Bellman), there remains some potential that some docs might prefer injections over transdermal because some docs administer the injections in the office and thus can charge for them. Just sayin’….
Androderm can be effective but a fair number of men (me included) can develop a hypersensitivity reaction to the adhesive. So i have pretty much stopped prescribing it (unless someone asks for it).
I always obtain follow-up total and free-T levels to assess the patient’s response. if someone seems to not be well absorbing Brand A I will switch to Brand B, etc. having said that, I probably use more Androgel 1.62% than any other formulation, and it is fairly rare in my experience that someone doesn’t respond. Then again, this is based more on blood level than on symptoms, because many of the potential symptoms of hypogonadism are somewhat non-specific, and may be due to other things, in which case they would not be expected to improve with replacement therapy. But if a man requests Testim I prescribe it, and so forth with Axiron, Fortetsta, etc. Alot has to do with what their insurance covers, as a $35/month co-pay beats hell out of $350 per month…..
All of the available preps are “bio-identical” testosterone, so a level is a level -there’s no scientific basis for thinking, given comparable blood levels between preps, that either efficacy or safety will differ between preps for testosterone replacement.
I said “testosterone replacement’ because that’s what I do, as opposed to supporting body building or sports success. Hypogonadism is related to loss of lean body mass & iincreased fat mass, leading to decreased insulin sensitivity and an increased risk of type 2 diabetes with its associated increase in CVD risk, as as to increased bone turnover leading to osteoporosis (increased risk of fracture). This is what I am treating/preventing in my patients (and myself).
EVERY treatment has its benefits and risks, and just as ERT is very appropriate for some but not all women, and can have some dose-dependent risks, so too with T replacement. Any normal range reflects the normal range in 95% of the healthy population, as opposed to the normal “range” for an individual. So just because the normal range might be 350-1100 does not mean that when you were 25 and WNL that your level was 1050. In fact, by definition, half of normal men have T level below the average value and half are above. So it is entirely possible that your “normal’ was 375, or 500, etc.
So given the potential risks of T-therapy (increased hematocrit in some men, increased clot risk, increased CVD risk in at least one study of older men, potentially increased risk of prostate cancer (more by enhancing growth of occult pre-existing malignant cells than actually “causing” cancer probably, etc.), I do not shoot for the 90th percentile in most men. In fact, in older men (who usually have a somewhat increased risk of both heart disease and prostate cancer), my target is reasonably close to the middle of the “normal range”, often jst below; in younger men, it might well be above the middle to about the 75th percentile, but rarely at the extreme upper end of normal. But it’s also titrated to the individual patient. So in me, 2 pumps of Androgel got me from 110 to around 380-400, my FSH came down, and symptomatically OK, so I’m OK with that level.
I know this will likely not sit well with most of this audience, who seem to be striving for the high end of the normal range. But everthing in medicine is a balnce of benefits vs. risks, and i thought you might be intersted in the academic endocrine viewpoint.
Endodoc,
I am at the upper end of normal, sometimes above even that. However, I would like to be somewhere in the middle of the road, probably between 500 and 600. I’m just waiting for my 24-year-old girlfriend to lose some of her sex drive. I guess I could probably give her a ring and a kid and that would happen quickly, wouldn’t it? 😉
The best TRT treatment I have found is called SottoPelle(Italian for “under the skin).
Pellets are implanted in the buttocks and dissolve over time delivering the testosterone
to your body evenly. The insertion is painless and replacement is about every four months or longer.
I went from 400 mg/dl to 1800 mg/dl in a very short time and I was 65 years of age at the time.
I went from curling 90 lbs 10 reps to 16 reps in a week. I also ran a 100 yd. windsprint in 14 seconds
with a body weight of 218 lbs. But, this may be typical for all former Air Commandos.
Dean I don’t now how good my insurance Aetna is but I started taking androgel 2 months ago and used some card the doc gave me and I only pay $10 a month. I just wonder how long that will last.
My history, I had been feeling sluggish and seing no gains at the gym and a loss in libido so I went in for a physical. I am 35 testerone was at 240ish. They did an mri and found a lesion on my pituitary glan. Still waiting to meet with endocrinologist for more on that.
Some days I feel the androgel is working others I don’t. I am only at one pump a day I think my PCP is a little hesitant to prescripe a guy with big muscles testosteronen One welcome change is I do have more erotic dreams and night time erections. I will try and find this site again after talking to my endocrinologist in a month.
Harry how did it go?
I was on testim at first, i hated putting it on…its sticky and the smell while women like it…It was a lil strong at times. I was paying nothing for testim which was nice. They have a nice coupon on there website. I decided to switch to androgel today so hopefully it was an ok move…my insurance covers both and I only paid $10 for the androgel. I hope this stuff works!
HI Endodoc,
I’m a long timer in the TRT business. I started with Androgel back in 2000. As it’s price sky rocketed I switched to injections which run me about $20/month. I inject each 7 days and it seems to work out all right. As you mention, I have skin problems with all sorts of adhesive products. At that time I was 285 pounds, had terrible CFS/FMS and congestive heart failure. I had muscle atrophy. The testosterone helped with fatigue and mood and energy. As a whole it had me feeling a lot better, but still terrible. Three years later I found MeCbl, followed by AdoCbl, L-methylfolate and l-carnitine fumarate with the other vitamins. I took off 85 pounds of water, 50 pounds of fat and put on 40 pounds of muscle regrowing normal muscle mass when I was able to resume exercising. I weigh 185 pounds or so now at 6′. My doctor and I have titrated the testosterone by effectiveness. At my present dose everything is normal and I get normal erections and function normally. At 10-20% less testosterone I stop getting erections. I no longer have CFS/FMS or congestive heart failure. None of the improvements happened until I got the right nutrients. My health for the last 10 years has been good, could hardly be better. Be in good health.
Endodoc
I have a situation and I was just wondering what you thought.. I am 47 & I take weekly T cyprionate ( although its a generic now ) injections. I started out at one level and my Hematocrit was high – 19? My T levels ( 5 days after the shot ) were in the upper 300 range – can’t remember the free levels, but it was good.The Endo cut my dose in 1/2 ( which didn’t bother me too much ) but my last blood work the hematocrit was still well over 19! ( actually a little higher than previously ) My Urologist wanted me to stop treatment, but I don’t see that ending well for me. Talked to my Endo and he is taking me off injections and putting me on Androgel. He says this can happen occasionally with those who use shots. Problem is, I used the gels a long time ago and they really didn’t work. My opinion is that there is something else going on – why would the hematocrit not drop, even rise, while the T shots were decreased??
Hello Bigball,
Have you thought about donating blood? I try to donate blood once every few months and find that it keeps my hematocrit levels down. If you can’t donate perhaps your doctor could remove some blood on a semi-regular basis and just destroy it instead of donating it. I agree about the gel —> I much prefer the shots.
Good luck and let us know how it goes!