A Closer Look at AndroGel



By William Llewellyn



This week I want to take a look at one of the most prescribed forms of testosterone in the United States, the transdermal hydroalcoholic gel (AndroGel). Ever since its release, there has been a strong push to educate doctors and the public on the benefits and relative safety of this drug. Many physicians have been moving their hormone replacement therapy (HRT) patients over to this form of testosterone replacement, and many others who were not comfortable prescribing testosterone drugs in the past began opening up their practices to this type of treatment. AndroGel certainly has been a market-changer in the United States.





AndroGel Overview





AndroGel is a transdermal testosterone gel. Testosterone is mixed into this alcohol- and water-based gel at a concentration of 1%. A penetration-enhancer is added to help carry the dissolved hormone through the skin and into the blood. AndroGel is applied to the skin once daily. Patients are instructed to rub the gel on the abdominals and/or upper arms, both areas that are covered by a short-sleeve shirt. This is to avoid contaminating others, as the skin serves as a constant reservoir for the hormone.





With regular once-daily use, AndroGel can maintain elevations in the serum testosterone level for the full 24-hour window. This medication has effectively replaced the need for testosterone injections, implants, or patches, and is perhaps the least invasive form of hormone replacement available.





Dosing and Blood Levels





Approximately 10% of the applied dose of AndroGel is absorbed through the skin. So each 5-gram packet delivers approximately 5 mgs of testosterone. Therapy usually begins at 5 grams per day, and is adjusted upward to 7.5-10 grams if blood testing shows an inadequate response.





The normal range for testosterone in men is roughly 300-1,050 ng/dL. Clinical studies administering 5 grams of AndroGel once daily to hypogonadal men for 180 days produced an average serum testosterone level of 555 ng/dL, and a peak of 830 ng/dL. The average was 713 ng/dL, and the peak 1,083 ng/dL, with the 10-gram dose. The 10-gram AndroGel dose resulted in levels stabilizing at the high end of the normal range. Seeking levels in this range, many patients push for the 10-gram dosage during therapy.





Clinical Advantages





Clinically speaking, there are a number of advantages to AndroGel. To begin with, it is painless. It is also very easy to use. This means that patient compliance is going to be high. Blood levels are also easy to control with daily dermal application. With injectable testosterone, patients typically endure supraphysiological (high) levels the first few days after an injection, and if the schedule is not timed correctly, often a few days of sub-therapeutic hormone levels before the next injection is given. AndroGel doesn’t really have the same highs and lows; it is much more consistent.





Disadvantages





AndroGel is slightly more prone to increasing DHT (dihydrotestosterone) levels, compared to injectable testosterone. This is due to the high prominence of 5-alpha reductase in the skin, which makes DHT from testosterone. This rarely is of clinical significance, however. Because the skin slowly absorbs the applied testosterone, AndroGel may not be the best option for people who like to spend a lot of time in the water. The directions recommend waiting at least five to six hours after applying the gel before showering. The outer skin does continue to hold a reservoir of testosterone all day, however. So if you want maximum absorption, any swimming is going to reduce delivery.





From a bodybuilding perspective, AndroGel is also a fairly difficult drug to misuse. A single 5-gram pouch holds enough gel to thoroughly cover the abdomen. Two pouches (10 grams) is a significant amount, and yet still unlikely to elevate testosterone levels outside of the normal range. For a noticeable anabolic effect, the user would probably need 20 grams per day (four 5-gram pouches). This should equate (roughly) to a weekly testosterone enanthate dosage of 200 mgs. This is a lot of gel to apply to the body, however, and would probably require using different sites such as the legs and lower arms. Also note that at a certain point, the skin will become oversaturated – and testosterone delivery will plateau. Results on par with a higher dose of injectable testosterone (say 400-500 mgs per week) may simply not be possible, even if you had eight to 10 packets a day.





Tips for Using AndroGel





I often receive e-mails from readers who have recently been prescribed AndroGel. One of the most common questions they ask is how to go about maximizing their results. Admittedly, there is nothing that will ever make AndroGel the drug of choice for bodybuilders. I can, however, provide a few small tips to help minimize the inadvertent loss of hormone throughout the day, and pull a bit more through the skin each day. The goal is consistent hormone absorption, and stabilization of testosterone at the highest levels possible for a given dose. Remember, always work with your doctor to make sure you are getting the proper response from the medication.





1. Take a shower before applying the gel. Make it hot so you open up the pores in your skin. Rub the gel on as soon as you dry off.





2. Leave your shirt off for a while, an hour if possible. Wet gel can absorb into the fabric. You will notice that the skin stays a bit sticky to the touch for some time after the gel seems dried.





3. Wear loose shirts. Even when dry, there is hormone coating your skin all day. Tight skin-hugging T-shirts can wipe some off.





4. Shave your body hair around the application areas. Gel that coats your hairs is not going to be absorbed through the skin.





William Llewellyn is widely regarded as one of the world’s foremost authorities on the use of performance-enhancing substances. He is the author of the bestselling anabolic steroid reference guide ANABOLICS and CEO of Molecular Nutrition. William is an accomplished researcher/developer in the field of anabolic substances, and is also a longtime advocate for harm reduction and legislative change. He built the website anabolic.org, an extensive online database of information on anabolic steroids and other performance-enhancing drugs.







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