Testosterone replacement therapy.

Hello,
I have had AFIB for about 3 1/2 years. I have been using Androgel for about 8 1/2 years. I use Androgel 1%, one 5 gram packet daily, which contains 50 mg of testosterone.

Recently I have come across several papers in which the authors question the amount of testosterone being prescribed and the testing methods being used. (I give links for two below).

In brief, they are saying that for topically applied testosterone, such as Androgel:
1. Topically applied sex hormones are well absorbed.
2. Standard blood tests for testosterone (venipuncture serum levels) give false low readings - they do not reflect the topically applied hormone.
3. The result is that many men are taking far too much testosterone.

Evidently typical topical use of testosterone is 50 - 100 mg daily. For comparison, a normal male produces approximately 6 mg daily.

Abnormally high testosterone and the cascading effects on other hormones and tissues cannot be good for heart health.

I thought I would ask if anyone on this Board has encountered these claims before I go off on a wild goose chase...
Thanks.

[www.power2practice.com]

[blog.zrtlab.com]

Sorry this guy is misinformed! ... Will explain in a few when back from Scottsdale.

Comprehensive 24 hour urine testing including all the major anabolic metabolites correlate quite well with serum total, free and bioavailable testosterone such that they generally tell the same story, saliva testing of people already taking exogenous hormones gives huge ranges that are not consistent and do not correlate well with positive clinical effects ..and most importantly both 24 hour urine and the new dried 24 hour urine testing DUTCH test as well as serum testosterone all do correlated very well with positive clinical outcome including beneficial cardiovascular effects.

More later, this is an area I am highly familiar with.. I've seen this website before and it's off base in my experience. Just no time to go into the details now, but his theory is mistaken..

Be careful what you read on many internet sites and its good you asked befoer assuming this was good info.

There is a long history now of huge numbers of men over the last 30 + years taking physiologic replacement dosing of testosterone .. doses will vary based on form of the hormone given and the base of delivery, but blood and 24 hour urine levels and correlation with all the major anabolic metabolites all connect the dots well and is very well vetted science.

Androgel is a poor delivery form compared to good quality compounded delivery systems .. but that is for another day. Will be checkin in the next few days but no time to go into a whole anabolic hormone pathway discussion and this would have to move to the General Health forum in any event where I will move it now to follow the thread there Vince as it is only indirectly associated with AFIB.

Many men over 60 do better with inhected hormones but topical
Is fine too if you use a high quality base and learn to rotate application sites to keep the receptor cells in the tissues from getting over saturated and thus the body turns off some degree of cellular receptivity over time thereby resulting in less absorption and often gradual return of deficiency symptoms again. Lots of folks taking testo don't understand this aspect and thus think all topical methods don't work well, but they very often do work fine and when applied twice a day in smaller intraday doses that delivery method better mimics our own endogenous pulsitile up and down hormone release in spurts during the day. There are a number of such nuances to such hormone treatment that can make a big difference in efficacy of treatment Vince.


Thanks
Shannon



Edited 1 time(s). Last edit at 11/05/2015 10:21AM by Shannon.

I haven't read in detail these articles and the reasoning behind it, but here is my opinion.

Anybody that has used male hormones and experimented, and done alot of research prefers injectable T over gels/patches, etc. It is more preciscely administered, as far as being able to predict a corresponding Serum T blood level.
So-called BHRT Doctors who are out to make money push the gels/patches, etc.

Whimpy Doctors who are worried that their patients will sell their T on the Black market feel more comfortable scripting Gels/Patches, etc. Try selling your Androgel to a Body-Builder, he would most certainly tell you he would only interested in a vial of serum.

I've commented on this subject before and some people seemed to find it very amusing but here goes.

The best way the increase your testosterone levels is the natural way. Improve the efficiency of your testes by testicular massage.

I did this some time ago and increased my testosterone levels by 50% in three months.

Google the subject and you'll find many sites showing you the procedure.

Thanks for replies thus far.

Further to my post of November 4, 2015, I have given below two more links to papers which get into much more detail on this theme.

What the author is saying is that serum blood testing is not reliable for monitoring topical delivery of progesterone, estrogens (estradiol, estriol, estrone) and androgens (testosterone, DHEA). Note that the author is being very specific that this statement only applies to "topical" delivery, meaning hormones applied to the skin in the form of creams, gels and patches.

I have looked through my blood tests while taking the Androgel:
• serum testosterone levels have been in the reference range.

However I did saliva tests at Rocky Mountain Analytical for cortisol and got the "male panel" done at the same time:
• saliva testosterone was much much higher than the endogenous reference range
• saliva estradiol was over two times higher than the upper limit of the endogenous reference range
• saliva DHEA-S was two times higher than the upper limit of the endogenous reference range

And recently I got serum tests for LH and FSH. Both of them were well below the lower end of the reference range.

It seems to me that all of these labs except the serum testosterone are indicating an excess of testosterone. And it seems to me that this supports the author's theory that the serum testosterone lab test reads too low in the case of topical delivery of testosterone.

Any comments welcome...
Thanks

these are the links I mention above:

[www.townsendletter.com]
[www.townsendletter.com]