Reason why TD application do not work..common sense wins again

[The Matrix]

While attending a Neuroscience seminar last night with multiple medical professionals, I ran into a PH.D of pharmacology. We started talking about gels and TD application as to the potential reason they do not work or give inconsistant results. We explored different types of carriers, bases , application sites still not getting a definitive answer. Then she mentioned "do you rotate sites"? I showed her how some well known HRT Dr's and compounding pharmacist noted to apply the gels. She replied "that's great, but the only problem is the area can be super saturated in a matter of a few days with some people, by rotating 4 different sites over the body this reduces the chance of down regulation of the delivery of the drug allowing for optimal absorption" I noted "This could possible explain the 1-2 week rush get on a Topical testosteorne?" She told me absolutely. So all the people taking androgel, T gels applying it to one area only may want to start rotating sites, Legs, calves shoulders, ect this might result in better absoprtion and plasma levels. Again some times the most complex problems have the simplest answers.

 

[RPHMark]

I always advise rotating sites. Even just using two sites (each shoulder, both sides of chest, etc) really seems to make a difference. I don't know that I buy the "saturation" model, but I do believe there is a difference in absorbtion, particularly as it applies to the rate.

 

[fanzdslpwr1]

would this apply to Sustain Alpha or Transaderm also?

 

[3clipseGT]

This is also why its important to scrub the spots you apply to in the shower.

 

[Gutterpump]

When I was on t-gels I didn't mess around with chances of malabsorption. I applied it to my forearms in the morning and again at noon. I realize it goes to your bloodstream very quickly that way, but that's why I split the dose. My labs showed great, stable levels. It was PLO gel as well.

 

[The Matrix]

Yes.but.look at direction in drs i have yet one to tell.me.to.rotate sites. Majority of hrt drs tend.to.forget to.mention.this to their patients. They just tell.them.to.rub forearm together each application. Rph can.you elaborate on how this will effect absorption of gels when applied just on forearms .

 

[Kekkuk]

What about axiron?

 

[B5150]

Try rotating 10ml of Androgel.

 

[RPHMark]

I don't like the forearm application idea for 2 reasons. One, there is virtually no fat layer under the skin (as well as the skin actually being thinner) in that area create any depot effect. I know there is not a great deal on the chest and shoulders but certainly more than on the forearm. Two, I don't believe most people rub the gel in well enough when using this method, which results in even more left on the surface. I have watched pts demonstrate the technique and rarely see them rub in the cream for more than about 10 seconds. That being said, I have seen pts have good results with it and in the calf area as well.

 

[fanzdslpwr1]

time to shave my calfs!!

 

[mattrag]

While attending a Neuroscience seminar last night with multiple medical professionals, I ran into a PH.D of pharmacology. We started talking about gels and TD application as to the potential reason they do not work or give inconsistant results. We explored different types of carriers, bases , application sites still not getting a definitive answer. Then she mentioned "do you rotate sites"? I showed her how some well known HRT Dr's and compounding pharmacist noted to apply the gels. She replied "that's great, but the only problem is the area can be super saturated in a matter of a few days with some people, by rotating 4 different sites over the body this reduces the chance of down regulation of the delivery of the drug allowing for optimal absorption" I noted "This could possible explain the 1-2 week rush get on a Topical testosteorne?" She told me absolutely. So all the people taking androgel, T gels applying it to one area only may want to start rotating sites, Legs, calves shoulders, ect this might result in better absoprtion and plasma levels. Again some times the most complex problems have the simplest answers.

Good info here.

 

[Gutterpump]

I don't like the forearm application idea for 2 reasons. One, there is virtually no fat layer under the skin (as well as the skin actually being thinner) in that area create any depot effect. I know there is not a great deal on the chest and shoulders but certainly more than on the forearm. Two, I don't believe most people rub the gel in well enough when using this method, which results in even more left on the surface. I have watched pts demonstrate the technique and rarely see them rub in the cream for more than about 10 seconds. That being said, I have seen pts have good results with it and in the calf area as well.

It was for this reason - the skin being thinner - that I used this method. I understand the cream will absorb almost immediately into the bloodstream with this method, but that's why I dosed twice daily, 8 am and 12-1pm. My labs, a few hours after dosing, were great (perfect). I didn't want to mess with absorption so I used an area where I know for a fact the skin is thin and absorption is maximized. My Dr also did not tell me to do this, nobody did. I did it after my own research.

 

[The Matrix]

It was for this reason - the skin being thinner - that I used this method. I understand the cream will absorb almost immediately into the bloodstream with this method, but that's why I dosed twice daily, 8 am and 12-1pm. My labs, a few hours after dosing, were great (perfect). I didn't want to mess with absorption so I used an area where I know for a fact the skin is thin and absorption is maximized. My Dr also did not tell me to do this, nobody did. I did it after my own research.

I went through a few hundred dollars of gels creames non worked. I applied it same spot on the forearms each time as I was told. Labs never got out of 300's. This sucks because I would prefer to use TD DHEA, but can not find anything to penetrate my skin. I have seen TD DHEA raise DHEA-S levels, but mine actually drop on TD dhea and urinary out put Quest no longer has. I am not dropping 200 bucks for rhein each time to see if the stuff is absorbing either. I have seen guys dump out over $600 bucks in gels and still not get any results clinical or verified through testing. I do not have money to waste. If a compounder told me I have a gel I guarantee to work and he's willing to put money on it by paying for the test if it doesn't then I would think about TD again ..

 

[Gutterpump]

I was using very small amounts of 20% PLO gel, if that helps. My test levels were ~1100-1500 (bit high) when I was using it on my forearms twice per day. Most of it applied to forearms and a very small amount to the nads, to help with DHT. (to my knowledge, there's very little 5-AR in forearm skin, if any - actually something I'd like to find out more about).

After I had that test done, I lowered the amount of gel I was using by almost half.

I now use shots though, which I find more convenient.

 

[The Matrix]

I was using very small amounts of 20% PLO gel, if that helps. My test levels were ~1100-1500 (bit high) when I was using it on my forearms twice per day. Most of it applied to forearms and a very small amount to the nads, to help with DHT. (to my knowledge, there's very little 5-AR in forearm skin, if any - actually something I'd like to find out more about).

After I had that test done, I lowered the amount of gel I was using by almost half.

I now use shots though, which I find more convenient.

With Dr's I have them if possible get a 10 days trial of the gel/ creame from compounding pharmacy (which they usually have no problem doing) then test levels after 7 days to see if it absorp. Will try may be 2 different kinds of gels and creams before having them invest the money. Since doing this it has benefit the compounding pharmacy as well as the clinical out come for the Dr's patient. Application will be done by rotating sites as directed by their Dr.

 

[Gutterpump]

Trials are the way to go...I didn't know they were available. Which cream do you find is the best overall?

 

[Whacked]

DMSO

but can not find anything to penetrate my skin.

 

[The Matrix]

DMSO

Have great penetration and smell like garlic breath or BO all day long or when I work out smell like rotten MEOW. I had that happen to many time when I used DMSO to heal injuries. LOL..

 

[The Matrix]

Try rotating 10ml of Androgel.

There are good compounding pharmacy which can mimic androgel at 1 ml vs 10...Something to consider..

 

[fanzdslpwr1]

what would you have to do? call around to each pharmacy and see if they can put the same dosage of test in 1ml?

 

[The Matrix]

what would you have to do? call around to each pharmacy and see if they can put the same dosage of test in 1ml?

No, dr usually works with one and could arrange it. Dr's do not get a monetary compensation for using them like people think. I know some charge $15 for ordering the prescription which is high way robbery, but thats beside the point.