I have two questions about using testosterone gel, according to the recommendations provided by Dr. Crisler in his video (https://www.excelmale.com/?s=74-Dr-John-Crisler-ON-Transdermal-Testosterone) on transdermal testosterone. I’m about a week and a half in (nothing to report yet), and I want to be sure I’m doing things correctly. Thanks in advance for the help!
1) It is said to avoid the blood draw site and surrounding area when using the forearms to apply the gel to your flanks, as this may cause a lab error. I’m trying to avoid that area, but I can’t say I’m doing a perfect job as there’s a fair amount of Testim gel to spread around and it tends to travel up the arms as it’s being applied. So, would it be sufficient to just completely avoid that area the day of the blood draw or for a few days beforehand? Or, does that skin “build up” testosterone over time so that it could impact blood test results for a longer period of time?
2) I am also curious whether the following study - which states that absorption is reduced when applying to the abdomen - is relevant to those of us who are applying to our flanks. A little gets on the abdomen when applying to the flanks (again, as it is a fair amount of gel so it spreads around), but not a lot. It’s a given that I want to maximize absorption, particularly since the doctor started me at 5 g per day, a relatively low dose.
http://www.ncbi.nlm.nih.gov/pubmed/21454244
Pharmacokinetics and relative bioavailability of absorbed testosterone after administration of a 1.62% testosterone gel to different application sites in men with hypogonadism.
Miller J, Britto M, Fitzpatrick S, McWhirter C, Testino SA, Brennan JJ, Zumbrunnen TL.
Abstract
OBJECTIVE:
To determine the pharmacokinetics, bioavailability, and safety of a new formulation (1.62%) of testosterone gel that produces eugonadal serum testosterone levels with use of a lower amount of gel than the currently available 1% gels.
METHODS:
In an open-label, randomized, 3-way crossover study, 36 male patients with hypogonadism applied 5 g of 1.62% testosterone gel (81 mg of testosterone) once daily to the abdomen, to the upper arms/shoulders, or alternating between both sites per an established schedule for 7 days. Serum levels of testosterone, dihydrotestosterone, and estradiol were measured and used to compare the pharmacokinetics and bioavailability of the 3 treatments.
RESULTS:
Each application method produced average serum testosterone concentrations within the eugonadal range (300 to 1,000 ng/dL), and steady-state testosterone concentrations were achieved after 2 days of gel application to either the abdomen or the upper arms/shoulders. When testosterone gel was applied to the abdomen, approximately 30% to 40% lower bioavailability (based on area under the serum concentration-time curve from 0 to 24 hours) was observed in comparison with application to the upper arms/shoulders. The 1.62% testosterone gel was found to be safe and well tolerated in men with hypogonadism.
CONCLUSION:
Although lower testosterone bioavailability was observed after abdominal application of 1.62% testosterone gel in comparison with application to the upper arms/shoulders, application to either site yielded eugonadal levels of serum testosterone.
1) It is said to avoid the blood draw site and surrounding area when using the forearms to apply the gel to your flanks, as this may cause a lab error. I’m trying to avoid that area, but I can’t say I’m doing a perfect job as there’s a fair amount of Testim gel to spread around and it tends to travel up the arms as it’s being applied. So, would it be sufficient to just completely avoid that area the day of the blood draw or for a few days beforehand? Or, does that skin “build up” testosterone over time so that it could impact blood test results for a longer period of time?
2) I am also curious whether the following study - which states that absorption is reduced when applying to the abdomen - is relevant to those of us who are applying to our flanks. A little gets on the abdomen when applying to the flanks (again, as it is a fair amount of gel so it spreads around), but not a lot. It’s a given that I want to maximize absorption, particularly since the doctor started me at 5 g per day, a relatively low dose.
http://www.ncbi.nlm.nih.gov/pubmed/21454244
Pharmacokinetics and relative bioavailability of absorbed testosterone after administration of a 1.62% testosterone gel to different application sites in men with hypogonadism.
Miller J, Britto M, Fitzpatrick S, McWhirter C, Testino SA, Brennan JJ, Zumbrunnen TL.
Abstract
OBJECTIVE:
To determine the pharmacokinetics, bioavailability, and safety of a new formulation (1.62%) of testosterone gel that produces eugonadal serum testosterone levels with use of a lower amount of gel than the currently available 1% gels.
METHODS:
In an open-label, randomized, 3-way crossover study, 36 male patients with hypogonadism applied 5 g of 1.62% testosterone gel (81 mg of testosterone) once daily to the abdomen, to the upper arms/shoulders, or alternating between both sites per an established schedule for 7 days. Serum levels of testosterone, dihydrotestosterone, and estradiol were measured and used to compare the pharmacokinetics and bioavailability of the 3 treatments.
RESULTS:
Each application method produced average serum testosterone concentrations within the eugonadal range (300 to 1,000 ng/dL), and steady-state testosterone concentrations were achieved after 2 days of gel application to either the abdomen or the upper arms/shoulders. When testosterone gel was applied to the abdomen, approximately 30% to 40% lower bioavailability (based on area under the serum concentration-time curve from 0 to 24 hours) was observed in comparison with application to the upper arms/shoulders. The 1.62% testosterone gel was found to be safe and well tolerated in men with hypogonadism.
CONCLUSION:
Although lower testosterone bioavailability was observed after abdominal application of 1.62% testosterone gel in comparison with application to the upper arms/shoulders, application to either site yielded eugonadal levels of serum testosterone.
