What time is best for blood test when on TestoGel

[FOX1]

Many people have different views on when blood should be taken whilst on Testogel TRT
.
Due to this I wrote direct to the manufacturer of Besins Testogel and asked their desired procedures for testing bloods whilst on Testogel.

They prefer a trough test
.
Here is their reply;
I am writing in response to your recent request for information on our product Testogel. You asked what time of day should testosterone levels be tested. You also asked for information regarding application of Testogel to the chest. I hope you find the following information useful.
The Summary of Product Characteristics (SPC) is a more detailed document than the Patient Information Leaflet (PIL), and is primarily written for healthcare professionals.
The SPC for Testogel
1 states in section 4.2 ‘Posology and method of administration’:

"Steady state plasma testosterone concentrations are reached approximately on the 2nd day of treatment by Testogel. In order to adjust the testosterone dose, serum testosterone concentrations must be measured in the morning before application from the 3rd day on after starting treatment (one week seems reasonable)"


I followed their procedure and my results were 18nmol/L (518ng/dl) trough, prior to application.

I also had a peak test 4 hours after application and this was what I considered high at 50.2nmol/L (1440ng/dl).
This falls to a trough of 18nmol/L (518ng/dl) 24 hours after application and prior to re-applying.

Do you consider these readings to high?

 

[madman]

Many people have different views on when blood should be taken whilst on Testogel TRT
.
Due to this I wrote direct to the manufacturer of Besins Testogel and asked their desired procedures for testing bloods whilst on Testogel.

They prefer a trough test
.
Here is their reply;
I am writing in response to your recent request for information on our product Testogel. You asked what time of day should testosterone levels be tested. You also asked for information regarding application of Testogel to the chest. I hope you find the following information useful.
The Summary of Product Characteristics (SPC) is a more detailed document than the Patient Information Leaflet (PIL), and is primarily written for healthcare professionals.
The SPC for Testogel
1 states in section 4.2 ‘Posology and method of administration':

"Steady state plasma testosterone concentrations are reached approximately on the 2nd day of treatment by Testogel. In order to adjust the testosterone dose, serum testosterone concentrations must be measured in the morning before application from the 3rd day on after starting treatment (one week seems reasonable)"


I followed their procedure and my results were 18nmol/L (518ng/dl) trough, prior to application.

I also had a peak test 4 hours after application and this was what I considered high at 50.2nmol/L (1440ng/dl).
This falls to a trough of 18nmol/L (518ng/dl) 24 hours after application and prior to re-applying.

Do you consider these readings to high?

One would want to test trough (lowest point) prior to application to make sure there testosterone levels are still in a descent range and providing the patient relief/improvement of low t symptoms and if one testosterone levels were too low at trough and the patient was not feeling benefits from therapy than the dose would need to be increased.

If you feel well overall I would say your trough is descent but it seems odd that your peak is so high as the difference is drastic unless you are using 100mg /day which would make more sense as a 50mg /day dose would not cause such a high peak.

Mind you your peak is very high.

 

[madman]

Here is a study on the PK effects of Androgel 1% on serum testosterone levels

- by day 30 the serum testosterone Cmax in the 50mg/day gel group was 875 (+/-) 57 ng/dl with a Cmin 360 (+/-) 39 ng/dl
- the serum testosterone Cmax in the 100mg/day gel group was 1198 (+/-) 56 ng/dl with a Cmin 504 (+/-) 27 ng/dl



https://academic.oup.com/jcem/article/85/12/4500/2852336

 

[madman]

Many people have different views on when blood should be taken whilst on Testogel TRT
.
Due to this I wrote direct to the manufacturer of Besins Testogel and asked their desired procedures for testing bloods whilst on Testogel.

They prefer a trough test
.
Here is their reply;
I am writing in response to your recent request for information on our product Testogel. You asked what time of day should testosterone levels be tested. You also asked for information regarding application of Testogel to the chest. I hope you find the following information useful.
The Summary of Product Characteristics (SPC) is a more detailed document than the Patient Information Leaflet (PIL), and is primarily written for healthcare professionals.
The SPC for Testogel
1 states in section 4.2 ‘Posology and method of administration':

"Steady state plasma testosterone concentrations are reached approximately on the 2nd day of treatment by Testogel. In order to adjust the testosterone dose, serum testosterone concentrations must be measured in the morning before application from the 3rd day on after starting treatment (one week seems reasonable)"


I followed their procedure and my results were 18nmol/L (518ng/dl) trough, prior to application.

I also had a peak test 4 hours after application and this was what I considered high at 50.2nmol/L (1440ng/dl).
This falls to a trough of 18nmol/L (518ng/dl) 24 hours after application and prior to re-applying.

Do you consider these readings to high?

The bioavailability of transdermal testosterone gels/creams range fro 9-14% absorption.

When one first starts trt using transdermal (gel/cream) steady state testosterone levels are achieved 48-72hrs after the 1st application.

Testim is stickier than Androgel and has been shown in some studies to have slightly better absorption in men using it.

 

[Vince Carter]

Wrong.

Testing on gels is always done, properly, 2hours post application and on the opposite arm of the blood draw.

 

[madman]

When one is first starting Testogel the dose should be titrated based on the predose morning serum concentration of total testosterone checked after at least 1 week of therapy initiation or after any dose adjustment.

One needs to know their trough (lowest point) when starting therapy after steady state has been achieved or after any dose adjustments.

Unfortunately there are still a lot of misinformed men using transdermals who apply the gel/cream and 2hrs later have blood drawn from the same arm near the applications site.....low and behold the lab results end up skewed.

I would be more concerned with my trough levels when starting therapy or dose adjustment and even than I would want to know my trough and peak levels at said dose.....thats just me though.

 

[FOX1]

One would want to test trough (lowest point) prior to application to make sure there testosterone levels are still in a descent range and providing the patient relief/improvement of low t symptoms and if one testosterone levels were too low at trough and the patient was not feeling benefits from therapy than the dose would need to be increased.

If you feel well overall I would say your trough is descent but it seems odd that your peak is so high as the difference is drastic unless you are using 100mg /day which would make more sense as a 50mg /day dose would not cause such a high peak.

Mind you your peak is very high.

.
@ Madman
apologies, I should have posted that I am on 101.25 mg of testogel per day, this is 5 pumps from the New "Besins" Testogel dispensing bottle rather than 2 x sachets (100mg).
one pump from dispensing bottle is 1.25grams / 20.25mg of testosterone. I would dispense this onto clean foil and apply to my skin to ensure full amount applied and none wasted on hands and do this for all 5 squirts. After 2 hours I then use Australian Gold sun cream and I find this soaks up any left over white residue on my shoulders
.
4 pumps (81mg) was giving me low "trough" tests and Urologist requested I went up to 5 pumps for 1 month, and then check both trough & peak
.

 

[FOX1]

@ Vince
Where did you get this information Vince?

Over the past 2 years on Gel, I have had 3 urologists and various doctors all with their own theories on when blood should be taken, one said exactly 6 hours after application, another said 4 hours after application and my own doctor backing up the manufacturers advice of 24 hours after application.
.
Due to so many different views, I decided to write direct the Manufacturer of Testogel;
addresses;
Besins Healthcare
Avenue Louise 287
1050 Brussels
Belgum

&
Laboratories Besins International
3 rue de Bourg l'Abbe
75003 Paris
France
.
Again I will print their reply below, this is direct from the manufacturer Besins" are you saying the manufacturer is wrong and advising the wrong way to test their developed product?
"Steady state plasma testosteroneconcentrations are reached approximately on the 2nd day of treatment byTestogel. In order to adjust the testosterone dose, serum testosteroneconcentrations must be measured in the morning before application from the 3rdday on after starting treatment (one week seems reasonable)"

 

[FOX1]

No others on Testogel on this forum?