Q: You recently answered a question here explaining that testosterone gel is best absorbed by areas of the body where there is less fat. I’ve been applying Androgel to my abdomen (stomach) and upper arms and shoulders as instructed by the manufacturer. Should I be applying it to other areas of my body instead? The gentleman asking the previous question stated that he was instructed to apply the gel to the shin, ankle and/or top of the foot. Thank you for your valuable work.
Nelson Vergel: Companies have to follow what it is shown in their medication label (package insert). They CANNOT say anything different since they may be promoting an off label use. And they can be fined for doing so.
Having said that, the companies that sell Androgel and Testim used the abdominal, shoulders and arm area in their studies, hence they tell people to use those areas only.
I have read two studies that measured blood levels of testosterone in men using different parts of the body, and those sections with lower fat tended to provide better pharmacokinetics. In fact, one of them found that the upper back section is the best. But, who can reach there?
A recent study showed that when a testosterone gel was applied to the abdomen approximately 30%-40% lower bioavailability (AUC0-24) was observed compared to upper arms/shoulders application. However, the study does not discourage using the abdominal area. Testosterone gel- abdomen versus shoulders/arms
A HIV related study found that Androgel can decrease waist circumference at about 1 inch in 26 weeks in men applying Androgel to their abdominals (the loss was mostly subcutaneous fat, not the deeper visceral fat that may be associated with metabolic problems). Would this same waist circumference reduction happen if we used other body areas? I have not seen any studies that attempt to answer this question.
However, be careful about applying testosterone to body areas that may come in contact with women or kids (if you have kids and need to hold them, for instance). Transference of testosterone to kids can affect them negatively. Transference of testosterone in women over periods of time can increase their risk of masculinization. So, legs (if you are wearing long pants) are not a bad idea.
One more thing: if you apply testosterone gel to your arms: you may get a very high testosterone blood level if your doctor tests for it since they extract the blood from your arm. The testosterone on your skin can be sucked in by the syringe and give you a false high reading. So, don’t apply the gel before your doctor’s visit (do it right after).
On November 2010, the US Food and Drug Administration (FDA) approved testosterone 2% topical solution (Axiron; Eli Lilly and Co and Acrux) as the first testosterone replacement therapy to be applied to the underarm, in much the same way as deodorant. This will make it easier to avoid transference to others.
I am yet to review their pharmacokinetic data to see how their product’s absorption is compared to other gels applied to abs, shoulders and arms. But keep in mind that this gel contains 2 percent testosterone instead of the 1 percent in Androgel and Testim, the two most popular prescription gels in the United States
I hope this helps!
Nelson
About the author
Nelson Vergel is the author of "Testosterone: A Man's Guide- Second Edition" and co-author of the book "Built to Survive: A Comprehensive Guide to the Medical Use of Anabolic Therapies, Nutrition and Exercise for HIV (+) men and women", the founder of the Body Positive Wellness Clinic in Houston, and an expert speaker on exercise, nutrition, testosterone replacement, metabolism , sexual function and therapies to increase lean body mass and decrease fat.
I read the article and agreed that the under-arms are messy and cannot be ideal for absorption into the skin. I use Axiron. I apply it to my arms and shoulders. Both have shown increase in muscle definition without training. I am 45 years old and my levels were 125 to 569 to 365. Should I go to injections?