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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Got Test results after 3 months 1% T-Gel . . . very rattled!
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<blockquote data-quote="madman" data-source="post: 277769" data-attributes="member: 13851"><p>Welcome to Nelson's domain!</p><p></p><p>Glad to have another fellow canuck on here.</p><p></p><p>Steady state is reached within the first 2-3 days.</p><p></p><p>Blood work should have been done 2 weeks after starting therapy not 3 months in as we need to make sure you are achieving a healthy TT/FT level let alone making sure you are a responder as many men never achieve the T levels needed to reap the beneficial effects of free testosterone due to absorption issues when using the transdermal formulations (standard application).</p><p></p><p>Scrotal application using a high-strength compounded T-cream is far superior!</p><p></p><p>When using Androgel/generic the manufacturer states that blood work should be done AM pre-dose morning blood draw.</p><p></p><p>T levels will peak 2-4 hrs (depending on the strength Androgel formulation 1-1.62%) post application and slowly decrease throughout the day as there should be a slow-sustained delivery of testosterone over 24 hrs.</p><p></p><p>The transdermal T-gel (Androgel/generic) should provide a steadier and more sustained release of T into the circulatory system.</p><p></p><p>Yes one can easily test at the peak or anytime after.</p><p></p><p></p><p><em><strong>*Some manufacturers provide both options (Table 11.2). Most testosterone gel preparations are formulated as hydroalcoholic gel, others use other enhancers in lotions. <u>When applied to the skin, testosterone is absorbed into the stratum corneum over time, which serves as a reservoir</u>. <u>Testosterone is slowly released into the circulatory system over several hours resulting in steady-state serum levels of the hormone</u> [22]. <u>The release of testosterone from the reservoir continues for about 24 h</u>.<u> Only approximately 10 % of the testosterone applied on the skin surface is absorbed into the circulatory system during a 24-h period</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong></strong></em></p><p><em><strong>*<em><strong>Long-term studies with testosterone gel have shown that <u>steady and relatively consistent serum levels of testosterone levels are attained</u> [7],</strong></em></strong></em></p><p><em><strong><em><strong></strong></em></strong></em></p><p><em><strong><em><strong></strong></em></strong></em></p><p><em><strong><em><strong>*<em>Several formulations of testosterone gels are available on the market [1, 2, 27]. <strong>Currently available gels vary in testosterone concentration and are usually applied once a day. T<u>heir pharmacokinetic profiles are also similar: Androgel 1 %®/ Testogel 1 %® [7], Testim® 1 % [28], Axiron®2 % [29] Fortesta Gel® 2 %/Tostran® 2 % [30], and Androgel 1.62 %® [31]</u>. </strong>These transdermal preparations have been proven to be efficient in normalizing serum levels, as well as the reversal of androgen deficiency symptoms for long periods of treatment [24], and have been considered an acceptable form of testosterone substitution by users [5]. <strong><u>The maximum concentration of testosterone achieved is variable depending on the preparation but usually within 2–5 h of application and is maintained for 24 h</u>. <u>When applied in the morning, a profile somewhat similar to the circadian rhythm in healthy men is maintained</u>.</strong> Recent studies in older hypogonadal men have shown that after testosterone gel application there were <u>large fluctuations in serum testosterone concentration both within and between patients</u> [8]. <strong><u>Skin structural differences may be one of the causes of these significant variations in the bioavailability of the drug, which poses challenges in predicting the effectiveness of medication and determining an adequate dose, as well as an appropriate time for testing serum testosterone levels</u> [8, 32].</strong> <strong>Nontime-dependent pulses of serum testosterone also occur in relation to exercise and skin temperature. Both factors may be mediated through changes in dermal blood flow.</strong> Another important issue is the possibility of blood sample contamination when it is drawn at the gel application site, which has led to a spurious increase in measured testosterone levels [33].<strong> <u>A sampling of blood after testosterone gel applications should be done away from the application sites</u>.</strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong></strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong></strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong>*<em><strong>Additionally, some gels include emollients that prevent skin drying and ensure better testosterone absorption. </strong>There are data to suggest that this may help achieve better bioavailability and higher serum concentrations [37].<strong> <u>Differences in gel formulations and their pharmacokinetic profiles are a reason why gels cannot be used and dosed interchangeably</u>. <u>Therefore, it is recommended to follow specific instructions on sites for application and dosing of the drug provided in the labeling</u>. <u>Dosing information and recommendations for some of the preparations are presented in Table 11.2</u>.</strong> It should be noted that some gels are marketed in various countries under different names but are in fact produced by the same manufacturer.</em></strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong><em></em></strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong><em></em></strong></em></strong></em></strong></em></p><p><em><strong><em><strong><em><strong><em>*<em>At day 90, <u>peak T levels were reached after 4 and 8 hours with 5 g and 10 g T gel application</u>, respectively.</em></em></strong></em></strong></em></strong></em></p><p></p><p></p><p>Ridiculous that your doctor would make you wait 3 months as you could easily crash off the hop if you ended up having absorption issues.</p><p></p><p>You are most likely using the generic version of Androgel which would be the 1% Taro-testosterone gel.</p><p></p><p>Most men are started on the lower dose of 5 grams gel 50 mg T (5 mg T/day) as the bioavailability of transdermal T (standard application) is around 9-13%.</p><p></p><p>Say roughly 10%.</p><p></p><p>Unfortunately such a dose will not result in stellar T levels as most men will need the higher-end dose 100 mg T (10 mg T/day) to achieve stellar/high FT levels and that is if you have no issues with absorption!</p><p></p><p>You tested at true trough (23 hrs) post application but even then your T levels are absurdly low!</p><p></p><p>Looks as though you are a poor responder.</p><p></p><p>More importantly although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.</p><p></p><p>Labs should always include TT, FT, estradiol, DHT, PSA and a CBC (complete blood count) which includes the critical blood markers RBCs, hemoglobin and hematocrit.</p><p></p><p>Unfortunately another downfall when it comes to testosterone therapy in Canada is that many of the endos, uros and GPs are still caught up on TT when FT is what truly matters.</p><p></p><p>Many end up only testing TT, PSA and CBC and ignore the most critical blood marker FT let alone estradiol, SHBG and DHT.</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/novel-administration-methods-for-treating-low-testosterone.27358/[/URL]</p><p></p><p></p><p><strong>*</strong><em><strong>Most of these preparations display a gradual increase, with a flat peak followed by a very slow decrease. Some ultimately increase slowly to peak a second time</strong></em></p><p>[ATTACH=full]42386[/ATTACH]</p><p></p><p>[ATTACH=full]42388[/ATTACH]</p><p></p><p></p><p><strong>Table 11.2 Characteristics of some testosterone gels (based on manufacturer’s label)</strong></p><p><strong>[ATTACH=full]42396[/ATTACH]</strong></p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/androgel%C2%AE-mechanism-of-action.24928/[/URL]</p><p>[ATTACH=full]42387[/ATTACH]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.taro.ca/en/canada-rx-product-details/428/Taro-Testosterone-Gel[/URL]</p><p>[ATTACH=full]42385[/ATTACH]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/new-trt-user-and-frustrated-on-1-62-gel.26537/#post-239692[/URL]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/safe-to-try-androgel-for-a-few-months-n-stop-it-it-doesn%E2%80%99t-work.28546/#post-266029[/URL]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/new-trt-user-and-frustrated-on-1-62-gel.26537/#post-239817[/URL]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/testosterone-therapy-in-canada.27300/[/URL]</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/canadian-urology-guideline-on-testosterone-replacement.22972/[/URL]</p></blockquote><p></p>
[QUOTE="madman, post: 277769, member: 13851"] Welcome to Nelson's domain! Glad to have another fellow canuck on here. Steady state is reached within the first 2-3 days. Blood work should have been done 2 weeks after starting therapy not 3 months in as we need to make sure you are achieving a healthy TT/FT level let alone making sure you are a responder as many men never achieve the T levels needed to reap the beneficial effects of free testosterone due to absorption issues when using the transdermal formulations (standard application). Scrotal application using a high-strength compounded T-cream is far superior! When using Androgel/generic the manufacturer states that blood work should be done AM pre-dose morning blood draw. T levels will peak 2-4 hrs (depending on the strength Androgel formulation 1-1.62%) post application and slowly decrease throughout the day as there should be a slow-sustained delivery of testosterone over 24 hrs. The transdermal T-gel (Androgel/generic) should provide a steadier and more sustained release of T into the circulatory system. Yes one can easily test at the peak or anytime after. [I][B]*Some manufacturers provide both options (Table 11.2). Most testosterone gel preparations are formulated as hydroalcoholic gel, others use other enhancers in lotions. [U]When applied to the skin, testosterone is absorbed into the stratum corneum over time, which serves as a reservoir[/U]. [U]Testosterone is slowly released into the circulatory system over several hours resulting in steady-state serum levels of the hormone[/U] [22]. [U]The release of testosterone from the reservoir continues for about 24 h[/U].[U] Only approximately 10 % of the testosterone applied on the skin surface is absorbed into the circulatory system during a 24-h period[/U]. *[I][B]Long-term studies with testosterone gel have shown that [U]steady and relatively consistent serum levels of testosterone levels are attained[/U] [7], *[I]Several formulations of testosterone gels are available on the market [1, 2, 27]. [B]Currently available gels vary in testosterone concentration and are usually applied once a day. T[U]heir pharmacokinetic profiles are also similar: Androgel 1 %®/ Testogel 1 %® [7], Testim® 1 % [28], Axiron®2 % [29] Fortesta Gel® 2 %/Tostran® 2 % [30], and Androgel 1.62 %® [31][/U]. [/B]These transdermal preparations have been proven to be efficient in normalizing serum levels, as well as the reversal of androgen deficiency symptoms for long periods of treatment [24], and have been considered an acceptable form of testosterone substitution by users [5]. [B][U]The maximum concentration of testosterone achieved is variable depending on the preparation but usually within 2–5 h of application and is maintained for 24 h[/U]. [U]When applied in the morning, a profile somewhat similar to the circadian rhythm in healthy men is maintained[/U].[/B] Recent studies in older hypogonadal men have shown that after testosterone gel application there were [U]large fluctuations in serum testosterone concentration both within and between patients[/U] [8]. [B][U]Skin structural differences may be one of the causes of these significant variations in the bioavailability of the drug, which poses challenges in predicting the effectiveness of medication and determining an adequate dose, as well as an appropriate time for testing serum testosterone levels[/U] [8, 32].[/B] [B]Nontime-dependent pulses of serum testosterone also occur in relation to exercise and skin temperature. Both factors may be mediated through changes in dermal blood flow.[/B] Another important issue is the possibility of blood sample contamination when it is drawn at the gel application site, which has led to a spurious increase in measured testosterone levels [33].[B] [U]A sampling of blood after testosterone gel applications should be done away from the application sites[/U]. *[I][B]Additionally, some gels include emollients that prevent skin drying and ensure better testosterone absorption. [/B]There are data to suggest that this may help achieve better bioavailability and higher serum concentrations [37].[B] [U]Differences in gel formulations and their pharmacokinetic profiles are a reason why gels cannot be used and dosed interchangeably[/U]. [U]Therefore, it is recommended to follow specific instructions on sites for application and dosing of the drug provided in the labeling[/U]. [U]Dosing information and recommendations for some of the preparations are presented in Table 11.2[/U].[/B] It should be noted that some gels are marketed in various countries under different names but are in fact produced by the same manufacturer. *[I]At day 90, [U]peak T levels were reached after 4 and 8 hours with 5 g and 10 g T gel application[/U], respectively.[/I][/I][/B][/I][/B][/I][/B][/I] Ridiculous that your doctor would make you wait 3 months as you could easily crash off the hop if you ended up having absorption issues. You are most likely using the generic version of Androgel which would be the 1% Taro-testosterone gel. Most men are started on the lower dose of 5 grams gel 50 mg T (5 mg T/day) as the bioavailability of transdermal T (standard application) is around 9-13%. Say roughly 10%. Unfortunately such a dose will not result in stellar T levels as most men will need the higher-end dose 100 mg T (10 mg T/day) to achieve stellar/high FT levels and that is if you have no issues with absorption! You tested at true trough (23 hrs) post application but even then your T levels are absurdly low! Looks as though you are a poor responder. More importantly although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects. Labs should always include TT, FT, estradiol, DHT, PSA and a CBC (complete blood count) which includes the critical blood markers RBCs, hemoglobin and hematocrit. Unfortunately another downfall when it comes to testosterone therapy in Canada is that many of the endos, uros and GPs are still caught up on TT when FT is what truly matters. Many end up only testing TT, PSA and CBC and ignore the most critical blood marker FT let alone estradiol, SHBG and DHT. [URL unfurl="true"]https://www.excelmale.com/threads/novel-administration-methods-for-treating-low-testosterone.27358/[/URL] [B]*[/B][I][B]Most of these preparations display a gradual increase, with a flat peak followed by a very slow decrease. Some ultimately increase slowly to peak a second time[/B][/I] [ATTACH type="full" alt="1711152857463.png"]42386[/ATTACH] [ATTACH type="full" alt="1711154615767.png"]42388[/ATTACH] [B]Table 11.2 Characteristics of some testosterone gels (based on manufacturer’s label) [ATTACH type="full"]42396[/ATTACH][/B] [URL unfurl="true"]https://www.excelmale.com/threads/androgel%C2%AE-mechanism-of-action.24928/[/URL] [ATTACH type="full" alt="1711154446122.png"]42387[/ATTACH] [URL unfurl="true"]https://www.taro.ca/en/canada-rx-product-details/428/Taro-Testosterone-Gel[/URL] [ATTACH type="full" alt="Screenshot (33752).png"]42385[/ATTACH] [URL unfurl="true"]https://www.excelmale.com/threads/new-trt-user-and-frustrated-on-1-62-gel.26537/#post-239692[/URL] [URL unfurl="true"]https://www.excelmale.com/threads/safe-to-try-androgel-for-a-few-months-n-stop-it-it-doesn%E2%80%99t-work.28546/#post-266029[/URL] [URL unfurl="true"]https://www.excelmale.com/threads/new-trt-user-and-frustrated-on-1-62-gel.26537/#post-239817[/URL] [URL unfurl="true"]https://www.excelmale.com/threads/testosterone-therapy-in-canada.27300/[/URL] [URL unfurl="true"]https://www.excelmale.com/threads/canadian-urology-guideline-on-testosterone-replacement.22972/[/URL] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Got Test results after 3 months 1% T-Gel . . . very rattled!
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