Doc won't prescribe injections but offered gel:

[Sterling]

I'm a 54 YO male with T levels consistently @200. Exercise 3 time per week doing full body with a day of rest in between. I'm about 5'11" 185lbs and have many of the common symptoms of low T - no morning wood (can't remember the last one), ED, low energy, no libido, increased fat, loss of muscle (despite workouts and a pretty good diet), mild depression etc. My PCP is willing to prescribe T but only gels or creams. He tells me he's gotten guys north of 1000 using these topicals. So, I'm interested to know your thoughts. I'm leaning towards a gel (Atrevis) but I have a concern about increased DHT. I'm a hair loss sufferer but I've done very well holding onto what I have and don't want to move backwards. Any ideas?

 

[Cataceous]

New doctor? Topical testosterone greatly raised my DHT and accelerated hair loss, but serum testosterone never stayed up consistently. Injections are the way to go if you don't want to push up DHT.

 

[Outcome]

I think you should get started on the cream since your T level is so low. And then start looking for a new doctor who specializes in trt. The Banner ads on this site are all very highly rated providers. Your hair loss could accelerate on injections as well as topicals. IMO it’s better to feel right than have nice hair. Mine is thinning and has accelerated on injections but I just consider it the next phase of my life.

 

[Mr S]

I'm a 54 YO male with T levels consistently @200. Exercise 3 time per week doing full body with a day of rest in between. I'm about 5'11" 185lbs and have many of the common symptoms of low T - no morning wood (can't remember the last one), ED, low energy, no libido, increased fat, loss of muscle (despite workouts and a pretty good diet), mild depression etc. My PCP is willing to prescribe T but only gels or creams. He tells me he's gotten guys north of 1000 using these topicals. So, I'm interested to know your thoughts. I'm leaning towards a gel (Atrevis) but I have a concern about increased DHT. I'm a hair loss sufferer but I've done very well holding onto what I have and don't want to move backwards. Any ideas?

I discussed T gels and creams with my urologist who was referred by my PCP. My urologist discussed injections as the most inexpensive option and he prescribed me Testosterone Cypionate. If your PCP doesn’t feel comfortable prescribing injections get a referral to see a urologist. Besides, you can object that the cost is too high to follow a protocol with cream.

 

[Vince Carter]

As far as costs got the stuff and I mean Androgel 1.62 is horribly expensive even with insurance picking up 50% I was paying $150 for a 2 week supply. That's just not sustainable for most any one.
If you have a compounded cream available I'd consider that over something from big Pharma. Hair loss is much more about genetics than hormones but if you're predisposed it could be a concern.

 

[captain]

Generic Fortesta with my insurance is $20 for 3 months. I didn't have much luck with Androgel. I think Androgel dries too fast. Always had good results with Fortesta.

 

[Tman]

I'm a 54 YO male with T levels consistently @200. Exercise 3 time per week doing full body with a day of rest in between. I'm about 5'11" 185lbs and have many of the common symptoms of low T - no morning wood (can't remember the last one), ED, low energy, no libido, increased fat, loss of muscle (despite workouts and a pretty good diet), mild depression etc. My PCP is willing to prescribe T but only gels or creams. He tells me he's gotten guys north of 1000 using these topicals. So, I'm interested to know your thoughts. I'm leaning towards a gel (Atrevis) but I have a concern about increased DHT. I'm a hair loss sufferer but I've done very well holding onto what I have and don't want to move backwards. Any ideas?

I had some success with fortesta other than the fact that my body would consume it all and I would be back to baseline 24 hours later. 6 pumps put me in / 1400 4 pump put me right around 900 dot-dot-dot but I was back to 200 24 hours later. Still it was better than dealing with low testosterone 24/7

 

[OMI100]

FWIW I started with androgel waaaaay back.
Waaaaaay too many tubes to be slopping on...
Tried Axiron and that worked well.
Got tired of the hoops I had to go through with insurance every year and the HIGH co-pay cost.
Switched to self-pay with Empower's 200mg/ml cream and have been using it for a looong time now.
Cost is reasonable and was less than my co-pay.
No experience with any of the newer generics, or if I would still have to jump through hoops to get it approved by my insurance company.
That's my story....

 

[captain]

I have been jumping through insurance hoop prior authorization every year. On some of my other prescriptions insurance and pharmacy are working together on a new hoop called backordered so you can't get it filled.

 

[Sterling]

My PCP does have a hookup at the local pharmacy for compounded creams or gels. Either runs about $55/month. I did some research and significant increases in DHT are real. I'll need to talk to my PCP to see what he recommends I take to offset the increase in DHT. I'm vain and would like to keep the hair I've fought for over the last 27 years.

 

[OMI100]

My PCP does have a hookup at the local pharmacy for compounded creams or gels. Either runs about $55/month. I did some research and significant increases in DHT are real. I'll need to talk to my PCP to see what he recommends I take to offset the increase in DHT. I'm vain and would like to keep the hair I've fought for over the last 27 years.

Depending on the strength of the compounded cream from your local source I wound see what Empower would charge for same.

 

[Cooper]

Generic Fortesta with my insurance is $20 for 3 months. I didn't have much luck with Androgel. I think Androgel dries too fast. Always had good results with Fortesta.

Captain - Always glad when I see someone on these forums who uses gels. Question if you don't mind. Have you ever tried injections or compound cream?

 

[captain]

No injection other than HCG. No creams other than DHEA and Preg.

 

[Vince]

I wonder what his reasoning is, refusing to prescribe injections. Apparently he doesn't have lots of experience in testosterone.

 

[Sterling]

I wonder what his reasoning is, refusing to prescribe injections. Apparently he doesn't have lots of experience in testosterone.

I'm not sure why he's hesitating. We talked about injections but he pushes the gels and I'm assuming he does this for a few reasons. Some of his guys have gotten great results, he says, and he trusts the pharmacy producing the compounds. He tends to be very leery of outfits he doesn't know. I guess I could always push it but if the gel works and I can keep DHT in check, I;m okay with not pinning myself frequently.

 

[Vince]

I'm not sure why he's hesitating. We talked about injections but he pushes the gels and I'm assuming he does this for a few reasons. Some of his guys have gotten great results, he says, and he trusts the pharmacy producing the compounds. He tends to be very leery of outfits he doesn't know. I guess I could always push it but if the gel works and I can keep DHT in check, I;m okay with not pinning myself frequently.

The main reason I was never interested in gels. I was too afraid of contaminating my lovely or my grandkids. When I started trt, I said if I had to use gels I wouldn't even consider trt. We are all different though, if that's not an issue with you, gels may be a better option.

 

[captain]

The levels of my wife. I know we have contact with the area of application and clearly it isn't a problem.
Testosterone 16 ng/dL Standard Range<40 ng/dL
Testosterone Free% 1.7 % Standard Range0.8 - 2.3 %
Testosterone Free Value 2.7 pg/mLStandard Range1.8 - 10.4 pg/mL

 

[Mr S]

I'm not sure why he's hesitating. We talked about injections but he pushes the gels and I'm assuming he does this for a few reasons. Some of his guys have gotten great results, he says, and he trusts the pharmacy producing the compounds. He tends to be very leery of outfits he doesn't know. I guess I could always push it but if the gel works and I can keep DHT in check, I;m okay with not pinning myself frequently.[/QUOTE
I guess that if you’re keeping him as your doctor for TRT you have no choice but to follow his protocol. All forms of exogenous testosterone will affect your hair if you’re prone to hair loss. It’s a given.

 

[Cataceous]

I guess that if you’re keeping him as your doctor for TRT you have no choice but to follow his protocol. All forms of exogenous testosterone will affect your hair if you’re prone to hair loss. It’s a given.

There can still be a big difference in relative DHT serum levels depending on the form of TRT. I have lab work when I was using Androgel with total testosterone at 160 ng/dL and DHT at 65 ng/dL. A couple months later on injections I had total testosterone at 1,250 and DHT at 50. Later still, on injections, I had total testosterone at 800 and DHT at 30.

 

[Mr S]

I’m sure there are differences DHT wise among all sorts of T administration but if you’re prone per studies you will lose your hair. You just don’t see it. It’s not like you’re molting. It’s not obvious like that till you notice thinning and changes that are irreversible . If you’re not prone to hair loss the story changes. However, it’s relative as people age and hair changes unfortunately. I don’t suffer from male pattern baldness but my hair has changed nonetheless. I’m almost 59 YO and having a head full of hair makes me look younger. Speaking of TRT and the fountain of youth...