Need some advice

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I have been using a compounded cream (MedQuest) for 2.5 years and I have generally been pleased with the results. The only downside is that we have had to increase the dose each year to achieve the same levels (we aim for the 900s and I am now applying 3 clicks 2X/day). I have been paying out of pocket and it is costing me about $65/month.

I have moved and I have a new provider (thankfully comfortable with my TRT). I have filled my last script (90-day supply) with the old provider so I have some time to figure out what to do next. I checked my new ins benefits and I can cut my out-of-pocket expense by half if I use one of the preferred brands. I am interested in the group’s collective experience. Here are the choices:

Androderm: how big are these patches? How common and troublesome is the skin irritation. Any trouble achieving decent levels? I would be pretty disappointed with levels of 600 which is what the package insert studies seem to show. I kind of like the idea that you can apply the patch and shower, etc without worrying about it. I worry that dose adjustments would be difficult.

Axilon: Dose adjustment seems fairly straight forward, but how do you travel with this stuff? It’s a liquid and the container is clearly more than 4 oz! The underarm application seems odd, but I guess I could get over it.

I appreciate your input in advance
 
Defy Medical TRT clinic doctor

HarryCat

Member
A urologist I had seen said that everyone he ever tried it on got a rash from the Androderm patch. I certainly did. I also found it barely budged my T number above baseline.
Also you need to apply it to a different place every time, so pretty soon you are putting it in places that will make it embarrassing at the beach/pool with big red rashes all over. Just a really bad option IMHO.

I don't have any experience with Axiron.
 

pmgamer18

Active Member
Yes I had the same problems with the patch at the time it just came out and my BCBS would not cover my Compounded T cream anymore. I had to put up with the rash for about 2 yrs until Androgel came out. Yet using 2 patchs / day got my levels much higher then 10 grams of androgel. On the patch I need to use an HC cream after taking the patch off so the rash would heal in 7 days before I needs to use that spot.

On Andogel I had a lot of joint and muscle pain the T from the gel was not supporting them and I was house bound for about 4 yrs on this. It was after I switched to Depo T shots that things got better for me. I have been on TRT over 33 yrs and seeing Dr.'s not up on this had me suffering for about 20 yrs not feeling 100%.

If you have a Thyroid problem it can make your skin thicker and the patch, creams and or gels don't get through the skin and you can't get good levels.

Here is a cut and paste from a post by Dr. M about this.
===============================================
Transdermal Hormone Replacement

[TD="class: thead"]

06-16-2009, 12:16 AM [/TD]

[TD="class: thead, align: right"] #

[/TD]

[TD="class: alt2, width: 175"]



Physician, Psychiatrist



Join Date: Mar 2009

Location: Carmel, California

Posts: 712



[/TD]

[TD="class: alt1"]

Quote:

Ideally, for hormone replacement
therapy, the transdermally based hormone is transferred into the fat layer of
the skin. From there, the hormone can be released gradually into the
bloodstream, producing stable level.

Alcohol-based gels are more useful
for hormone replacement since they allow the hormone to be absorbed into the
skin fat and to be slowly released into the blood stream.

Oil-based
transdermal gels or creams - such as the PLO gels - are good for rapidly
introducing substances into the system. They aren't as useful for hormone
replacement therapy because they cause the hormone to bypass the skin fat and
allow the hormone to directly go into the blood stream. This causes a large peak
and a rapid fall in blood levels.

Both alcohol-based and oil-based gels
or creams will result in good absorption generally. They generally result in
predictable blood levels of hormones and medications. If the blood level does
not go up, then it is not being absorbed. Thus if a testosterone transdermal
does not result in an appreciable increase in testosterone it is not well
absorbed.

Some people will have difficult absorbing a transdermal
preparation. For example, people with hypothyroidism, can develop mxedema. This
is a thickening of the skin due to the accumulation of mucin - a glue that holds
cells together. This prevents transdermal absorption. In my patients, if a
person develops lower thyroid hormone levels from either transdermal
testosterone or estradiol, testosterone and estradiol levels fall. When I
address thyroid hormone, testosterone and estradiol will again be abssorbed and
levels rise. Other reasons for non-absorption include possible ethnic
differences or genetic differences in skin such as oilier skin, etc.

One
other reason a hormone level does not go up is that the dose used is too low.
For example, many patients are given one 5 gram packet of Androgel to use. This
is too low for many men. Since there is negative feedback controlling
testosterone production, at a certain dose, the dose is too low to make up for
the loss of one's testicular testosterone production, when exogenous
testosterone is added. Testosterone level actually will decrease when only 1
5-gram pack is used in many men. The percentage of men where testosterone will
be low rather than high decreases when two 5-gram packs of Androgel are used.
This would be the starting dose I would use. In these men, there is evidence of
absorption - such as DHT (dihydrotestosterone) levels going up. But testosterone
is either the same or LOWER. In these men, testosterone in Androgel IS absorbed.
But the dose is too low.


__________________
Romeo B. Mariano, MD, physician, psychiatrist
Any
information provided on

is for informational purposes only, is
not medical advice, does not create a doctor/patient relationship, is not
exhaustive, does not cover all conditions or their treatment, and will change as
knowledge progresses. Seek the advice of your physician or other qualified
health provider before undertaking any diet, exercise, supplement, medical, or
other health program.
[/TD]


Today I do Test C shots 80 mgs E3D subQ and I do 250 IU's of HCG to keep my testis working the day before my Test C shot E3D and I take Aromasin to keep my Estradiol down. I find this recipe works great for me I eat up the T as fast as I can take it and my SHBG is on the lower side at about 15 to 20.
A urologist I had seen said that everyone he ever tried it on got a rash from the Androderm patch. I certainly did. I also found it barely budged my T number above baseline.
Also you need to apply it to a different place every time, so pretty soon you are putting it in places that will make it embarrassing at the beach/pool with big red rashes all over. Just a really bad option IMHO.

I don't have any experience with Axiron.
 

Nelson Vergel

Founder, ExcelMale.com
Here is info about each option. https://www.excelmale.com/forum/threads/1487-Testosterone-Replacement-Treatment-Options


The patch is outdated and hardly anyone uses it unless they do not know what they are doing.

When it comes to out of pocket expenses, if your copay is more than $40 per month you are probably better off with a 2-5 percent testosterone cream made by a compounding pharmacy since that would cost you about $50 and get your levels higher than using Androgel, Testim, Fortesta or Axiron.

Information about financial assistance for testosterone products
 
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