Testogel- first time user

I've been in contact with the pharmacokinetics dept at Besin healthcare and this is their reply. 

I can only assume that the trials group didn't need so much testosterone as they were given the lowest dose and maybe as you need more, it's not efficacious enough at a higher dose.

Although, the new pump is more concentrated per gram, it's not more concentrated per dose. 

It's 20% less and with the lower percutaneous absorption rate than the 1% sachet, it becomes even lower.

Quote:

Concentration comparison

I can confirm that the 16.2mg/g is a more concentrated gel as compared to the 1% (10mg/g) gel. This means that patients can apply less gel to achieve comparable results.

The 16.2mg/g delivers 40.5mg of testosterone vs 50mg of testosterone in a single 1% sachet as per recommended starting dose. Therefore, the patient is receiving a more concentrated dose but not a stronger preparation.

Efficacy of 16.2 mg/g gel vs 50mg sachets

I can confirm that Testogel 16.2mg/g gel is comparable to Testogel 50mg gel sachets.

Even though there are no direct head-to-head studies, pharmacokinetic data suggests that comparable Cavg testosterone levels are achieved over 24 hours from 2 actuations of the 16.2mg/g pump (40.5mg) as compared to Testogel 50mg sachet:

• 5g of a 50mg sachet – At Day 180, T levels were 19.2nmol/L (Swerdloff et al 2000)1
• 2.5g of 16.2mg/g (40.5mg) – At Day 182, T levels were 17.1nmol/L (Kaufman 2011)2

Both of these achieved T levels are within the target therapeutic range of 15-30nmol/L which is the recommended level from the 2017 BSSM androgen guidelines3.

To see results from a trial on Testogel 16.2 go here: www.jsm.jsexmed.org/.../fulltext

It reads that Testogel 16.2 has a higher permeation rate than other gels but that isn't what EMC states in the pharmacokinetics section.

So, still confused

Hi,

They may well be comparing with Testim, which no-one seems to like and stays tacky for an awfully long time, they don't say they are comparing against testogel sachets?

G.

Okay, I may put a spanner in the works here, as I have just had my blood results back from increasing to 5 pump actions per day

Peak Testosterone 50.2 nmol/L (this was taken exactly 4 hours after application for max absorption)

Trough Testosterone 18.0 nmol/L (this is the one Besins advise for bloods i.e. blood taken 1st thing in morning before putting on cream)

I have just emailed my doctor and he will be calling me within the next hour

here is what I emailed him;

eek 50.2 is very, very high...almost sounds like a bad test result. I should get my results tomorrow for 4 pumps.

G.

@ Greg;

were your blood tests  4 pumps taken before or after application?

I initially thought 50 was high, but my doctor said if I was at 18 prior to application and then administering 5 pumps, he would expect it to rise quickly, and then drop off through out the day. He seemed to be happy with this result and said not to be alarmed by the "peak" test.

He also has a copy of the Besins instructions for taking bloods and considers 18 a good result.

.

I will be seeing my "privately paid Urological Surgeon" on Monday and we will check all my bloods over past 2 + years as we have graphs of all results, I will let you know what he recommends.

.

I will also forward results to Besins for their view on this.

I must admit, I am starting to feel normal again, when initially starting on testogel pump, my levels dropped to 6nmol/L and my muscles really ached with gym work outs as well as lots of sweats at night (sleeping).

Now I am on 5 pumps, it appears to be working?

.

does anyone on here get both "Peak & Trough" results or just trough results

or

do you get tested after application and consider it as trough? when its actually peak

What dose were you on when results were 6nmol/l?

My doctor seems to think it doesn't make much difference having blood taken a few hours after administration. But that obviously isn't the case with you.

That's what I thought, so researched percutaneous absorption of other brands.

Testim is 10%

Tostran 12%

Testogel 10 - 14%

But I also found out, the longer it takes for gels to dry, the more your body absorbs. As soon as the alcohol has evaporated, the residue of active ingredient is left on top of your skin. This would go someway to explaining why Testogel 16.2 doesn't absorb so well.

And another trial read that putting sun lotion or moisturizer on after applying gel increases the absorption rate  10 - 12% because it stops the gel drying too quickly.

That might help a lot with the pump.

Interesting!

I was on 2 sachets Testogel (2 x 50mg) for 2 years, then with hassle of supply start of this year I went on to the pump dispenser @ 4 actuation pumps per day for 1st 2 months

that's when I got a phone call from my doctor saying results were low at 6nmol/L

.

both my doctor & urologist agreed I should increase to 5 pump actuations per day, done this for a full month, applying to arms & shoulders, occasionally to upper thighs, after a couple of hours I would use Aussie Gold sun tan lotion on top just to soak in the residue and that's when I got the results

I really don't know what to make of the peak result apart from it being a wrong reading!

but for past 3 months I have had 3 months worth of blood tests and my NHS in Tayside  are not happy with so many frequent checks.

I may get my own tests arranged private on Monday when I see my private Urologist, costs a fortune through Spire healthcare.

..

My local pharmacy called Besins direct yesterday, they said they could not give a date when they would return to supply sachets

My pharmacist contacted Besin earlier this week and have fulfilled my latest prescription for sachets, so that's a relief.

Had this email/letter from:

Medical Information Department

ProPharma Group on behalf of Besins Healthcare (UK) Ltd

I can confirm that we are continuing to experience difficulty in the supply of Testogel 50mg gel in a sachet formulation.
Unfortunately we do not have an expected return date and the supply issue is likely to continue for the foreseeable future.

I am sorry to hear you have experienced these issues whilst taking Testogel. We have passed details of this onto our Drug Safety Department who may contact you under separate cover to obtain further details about your case.

--------------------------------------

So, at least they're listening.

Sounds like the sun lotion made a huge difference because I take 1.5 sachets and 4 pumps wasn't enough.

As regards blood tests, this should be a necessity as it's so important to get the correct results. I don't think GP's are getting the importance of the issue and how debilitating it can be.

My doctor wanted me to go back on the pump and wait two weeks before testing but I don't want to feel so unwell again, so I shall request a trough blood test 4 days after trying again.  I might even go private to my endocrinologist if they won't allow it. The GP also doesn't think taking peak or trough tests will give different results !!???

I'd like to take use the pump as it's much easier but it's got to work.