I have been using bio-identical cream from compounding pharmacy for the last 2 years with some mixed results. At the beginning my T-LEVELS WERE close to 470 and then after a while started to decline to a level of 270. I was applying it to the shoulder area for the whole time. I am working with a new integrated medicine doctor who advised me to switch to other areas of the body with less muscles like inner thighs, the back side of my knee and my inner arms. The idea is that with less muscles the absorption would be better. It's been a week and I do not notice a change. My question is how long does it take for the body to adjust? my doctor wants me to try it for 3 months before next blood test, does that make sense to wait that long?
bio-identical cream absorption issues
- Thread starter ymeromy
- Start date
Vince
Super Moderator
posted by Nelson https://www.excelmale.com/forum/sho...-that-Can-Improve-Testosterone-Gel-Absorption
Most absorption of testosterone in testosterone gels happens during the first 4 hours. The 1.62 % Androgel package insert says this about showering after testosterone gel application and using moisturizers/sun block:
"Effect of showering
In a randomized, 3-way (3 treatment periods without washout period) crossover study in 24 hypogonadal men, the effect of showering on testosterone exposure was assessed after once daily application of AndroGel 1.62% 81 mg to upper arms/shoulders for 7 days in each treatment period. On the 7th day of each treatment period, hypogonadal men took a shower with soap and water at either 2, 6, or 10 hours after drug application. The effect of showering at 2 or 6 hours post-dose on Day 7 resulted in 13% and 12% decreases in mean Cavg, respectively, compared to Day 6 when no shower was taken after drug application.
Showering at 10 hours after drug application had no effect on bioavailability. The amount of testosterone remaining in the outer layers of the skin at the application site on the 7th day was assessed using a tape stripping procedure and was reduced by at least 80% after showering 2-10 hours post-dose compared to on the 6th day when no shower was taken after drug application.
Effect of sunscreen or moisturizing lotion on absorption of testosterone
In a randomized, 3-way (3 treatment periods without washout period) crossover study in 18 hypogonadal males, the effect of applying a moisturizing lotion or a sunscreen on the absorption of testosterone was evaluated with the upper arms/shoulders as application sites. For 7 days, moisturizing lotion or sunscreen (SPF 50) was applied daily to the AndroGel 1.62% application site 1 hour after the application of AndroGel 1.62% 40.5 mg. Application of moisturizing lotion increased mean testosterone Cavg and Cmax by 14% and 17%, respectively, compared to AndroGel 1.62% administered alone. Application of sunscreen increased mean testosterone Cavg and Cmax by 8% and 13%, respectively, compared to AndroGel 1.62% applied alone. "
This graph shows how applying on shoulders (treatment B) gets blood levels of testosterone higher than applying testosterone gel on abdominal area (treatment A). It is probably related to the lower amount of fat in the shoulders that makes it easier for testosterone to get to the blood stream.
Message:
1- Applying on shoulders gets more testosterone absorbed by abdominals.
2- Showering or sweating after 4 hours is OK.
3- Using moisturizers or sunblock after applying testosterone gels increases absorption by 8-13 percent.
Attached Images
Most absorption of testosterone in testosterone gels happens during the first 4 hours. The 1.62 % Androgel package insert says this about showering after testosterone gel application and using moisturizers/sun block:
"Effect of showering
In a randomized, 3-way (3 treatment periods without washout period) crossover study in 24 hypogonadal men, the effect of showering on testosterone exposure was assessed after once daily application of AndroGel 1.62% 81 mg to upper arms/shoulders for 7 days in each treatment period. On the 7th day of each treatment period, hypogonadal men took a shower with soap and water at either 2, 6, or 10 hours after drug application. The effect of showering at 2 or 6 hours post-dose on Day 7 resulted in 13% and 12% decreases in mean Cavg, respectively, compared to Day 6 when no shower was taken after drug application.
Showering at 10 hours after drug application had no effect on bioavailability. The amount of testosterone remaining in the outer layers of the skin at the application site on the 7th day was assessed using a tape stripping procedure and was reduced by at least 80% after showering 2-10 hours post-dose compared to on the 6th day when no shower was taken after drug application.
Effect of sunscreen or moisturizing lotion on absorption of testosterone
In a randomized, 3-way (3 treatment periods without washout period) crossover study in 18 hypogonadal males, the effect of applying a moisturizing lotion or a sunscreen on the absorption of testosterone was evaluated with the upper arms/shoulders as application sites. For 7 days, moisturizing lotion or sunscreen (SPF 50) was applied daily to the AndroGel 1.62% application site 1 hour after the application of AndroGel 1.62% 40.5 mg. Application of moisturizing lotion increased mean testosterone Cavg and Cmax by 14% and 17%, respectively, compared to AndroGel 1.62% administered alone. Application of sunscreen increased mean testosterone Cavg and Cmax by 8% and 13%, respectively, compared to AndroGel 1.62% applied alone. "
This graph shows how applying on shoulders (treatment B) gets blood levels of testosterone higher than applying testosterone gel on abdominal area (treatment A). It is probably related to the lower amount of fat in the shoulders that makes it easier for testosterone to get to the blood stream.
Message:
1- Applying on shoulders gets more testosterone absorbed by abdominals.
2- Showering or sweating after 4 hours is OK.
3- Using moisturizers or sunblock after applying testosterone gels increases absorption by 8-13 percent.
Attached Images
It doesn't really make sense to wait 3 months before checking levels again. With cream, the half life is very short so you could test as soon as 2 weeks to know if you are absorbing it. This is also why the timing of the blood draw is also important. If you test 2-3 hours after application you will catch the peak levels, if you wait 5-6 hours you will get more of the middle level, and of course if you wait a day you will get a trough, which won't tell you if you absorbed any or not.
With injections the half life is much longer which is why it is advisable to wait 5-6 weeks before testing.
With injections the half life is much longer which is why it is advisable to wait 5-6 weeks before testing.
Part of it depends on where you apply it. From what I've read, if you apply it on the shoulders there is more fat than on the inner thighs, inner arms or scrotum, so it evens out the release into the blood stream.
Dr's Shippen and Crisler believe in testing at the peak because that is the only way to know if you are absorbing it, and if so, how much.
For example, I currently apply to the scrotum and if I test 2-3 hours after application my total T tests over the top of the range, if I wait 5-6 hours, I test at about the middle of the range. I've not tested myself a day after application so I don't know what my trough would be. I only apply the cream once per day.
Dr's Shippen and Crisler believe in testing at the peak because that is the only way to know if you are absorbing it, and if so, how much.
For example, I currently apply to the scrotum and if I test 2-3 hours after application my total T tests over the top of the range, if I wait 5-6 hours, I test at about the middle of the range. I've not tested myself a day after application so I don't know what my trough would be. I only apply the cream once per day.
CoastWatcher
Moderator
You are absorbing sufficient testosterone to shut down natural production, but your body is not absorbing it sufficiently to raise your overall level,to therapeutic levels. Which is an all too common problem with topicals. None the less, see if following some of the suggestions noted above. How are you feeling?
Vince
Super Moderator
can't find much on creams, I've always injected. There is one post you find interesting https://www.excelmale.com/forum/showthread.php?1051-Scrotum-application-of-testosterone
Is your doctor opposed to you going on twice weekly injections instead of the topical? Many, many guys have absorption issues with the topicals and have switched to injections for that reason. Once you have tried putting the topicals basically every possible place on your body and it is still not working right - why fight it? Definitely don't wait 3 months while feeling like crap the entire time. My 2-cents 
How do you feel? Side effects?
I see you posted numbers but if you feel good or have side effects under control whats the prob? Dont over think this....
I use a compounded cream that I primarily apply to inner thigh. Because it has more body fat there, I need to manage E2 as it converts in the fat cells. I do not notice any difference in feeling good or all the benchmarks whether I use Crislers method of inner arms to sides or shoulders. I switch up all the time so I dont have any specific blood work to compare sites.
My DHT runs high so not sure if I get alittle cross contamination on the ball sack in the groin area or if I just convert to higher levels of DHT.
As long as I feel good, I dont worry about it. I was going to switch to injections with a new doc but since I respond well to TD we stayed the course. My T runs in the 800's so no point in changing protocol
I see you posted numbers but if you feel good or have side effects under control whats the prob? Dont over think this....
I use a compounded cream that I primarily apply to inner thigh. Because it has more body fat there, I need to manage E2 as it converts in the fat cells. I do not notice any difference in feeling good or all the benchmarks whether I use Crislers method of inner arms to sides or shoulders. I switch up all the time so I dont have any specific blood work to compare sites.
My DHT runs high so not sure if I get alittle cross contamination on the ball sack in the groin area or if I just convert to higher levels of DHT.
As long as I feel good, I dont worry about it. I was going to switch to injections with a new doc but since I respond well to TD we stayed the course. My T runs in the 800's so no point in changing protocol
Gene Devine
Super Moderator
A big problem here is your transdermal is a cream and not a gel.
You need your TD to be compounded in gel form and rub it in on your ribs and forearms just after a hot shower.
Creams don't absorb nearly as well as gels in men.
You need your TD to be compounded in gel form and rub it in on your ribs and forearms just after a hot shower.
Creams don't absorb nearly as well as gels in men.
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