T Nation

Why Did You Choose Topical Gels/Creams Over Injections?


#1

This goes out to the few and the proud that chose topical creams or gels over injections. What lead to your decision to choose creams/gels over injections? Can you be specific as to the factors such as mood, libido, blood work, energy, estrogen management, more stable blood levels that might have lead to your decision? Thanks in advance.


#2

You’re not going to find many topical advocates on here. Injections are the way to go and I would suspect most who don’t go that route are scared of pins.


#3

Parts of the healthcare system act like injections need to be avoided while ignoring the high costs of topicals.

“Bio-identical” is misused as a topical T marketing tool. T esters injected in oils are a bio-identical time release delivery as your body strips off the ester groups.

Self-injected T is least cost and 100% absorbed.

Topicals have highest T–>DHT potential, mostly good unless you have hair loss disposition.

Topicals often not absorbed when there are thyroid issues.


#4

I am on Tostran and actually quite happy about it. Sure, it is a bit more work than injections but seems to work good for me so far (6 mths). Some of the advantages with gel that I see are the ability to regulate the dosage on a short basis.

For example, on training days I somethines put on a bit extra to get some extra boost. Same thing if I happen to get own time with wife :wink:

I also do short periods (say 1-2 weeks) when I double the dosage to put on a little extra muscle.

Overall, I have gained about 8 lbs since I started with tostran, which is more than I have gained in the last 3 years.I estimate all of it to be lbm (might even have droped a pound or two in fat).

Another advantage with gels is that it does not affect your liver. The testosterone is just pure T which is directly absorbed into your bloodstream through skin. When you inject, the T is bound to an ester (cyp, ent or undecanoate if you go with Nebido) and the liver has to do some work to free the T from the ester. Not sure how big of an issue this is though.

I am 48, been lifting weights for 35 years.


#5

So does this also mean it doesn’t affect SHBG which is produced in the liver?


#6

I have no idea about that. What I meant was that gels does not put an extra burden on your liver.

Some studies suggest that TRT reduces SHBG (see link below) but I have heard some people claim that it increases it. I do not know if the route of administration (inject vs gels) does make any difference.

Maybe there are other people who knows more about this?


#7

Oral testosterone is associated with liver toxicity.

I haven’t seen anything that says there’s an issue with injections.


#8

Rizzle

First of all, there is practically no oral testosterone (except oral test undecanoate, which is very innefective or methyltest which is very liver toxic), which is why TRT is given as either Gels/cream or injections. If you were to take oral test, it is destroyed in the liver during the first pass as it goes directly from digestive sytem to the liver via the portal vein.

Yes, oral anabolics are more liver toxic than injectables due to the first pass mechanism but injectable steroids also put a burden on the liver. I do not know if this is an issue for injectable Test as well (although a friend of mine got slightly elevated levels when he started injectable TRT). In order to separate the test from the ester, the liver have to do some work so I assume it must put some burden on the liver but probably it is not a big issue for most as you write (at least at TRT dosages).

Best Regards


#9

I know there are practically no oral testosterones.

But I think by saying you chose gels over injections because injections cause liver issues is a very suspect thing to say.

Oral consumption is really the only method that shows any discernible detriment to the liver.

I have yet to read a study that says a anything related to decreased liver health from injections.

I have never talked to a urologist or endo who is concerned about liver health with injections.


#10

Rizzle, please read my post again. Nowhere do I claim that injections causes liver issues.

I wrote that the main reason that I choose gel is the ability to regulate T levels on a daily basis, which is not possible with injections. To that, I added that another reason is that it does not affect your liver as the Test goes directly to blood (not bound to an ester) but that I didnt knew if this realy was an issue.

Please compare a gel (e.g. tostran) and nebido in UK medical lookup regarding liver issues:
https://www.medicines.org.uk

Tostran: In very rare cases jaundice and liver function test abnormalities
Nebido: Liver function test abnormal, Aspartate aminotransferase increased (listed as uncommon but not rare)

From this, I conclude that liver issues with injections are uncommon but not rare and present to a larger extend than with gels, which is logical given that the liver has to separate the test from the ester.


#11

My point is that when someone asks why did you choose gel, and your response says there’s less load on the liver and gels do not affect the liver, you’re implying injections cause liver issues.

Also on that link the tests were done with between 750-1000mg!

Someone could already have an underlying condition. And of course supraphyisiogical doses could cause problems.

However Even on that link they say “considered at least possibly causally related to Nebido.”

So the correlation of injections and liver function is modest at best.

As stated before I’ve yet to read a study that shows adverse problems relating to the liver for TRT.

My whole point is simply if someone sees your response and doesn’t dig further or ask questions they can easily walk away with a concern pertaining to liver function that isn’t really an issue.

That’s all :slightly_smiling_face:


#12

Rizzle
Point taken, I assume I could be more clear in my original post but as I stated in my later posts, my intent was not trying to imply that injections give liver problems but rather to say that they affect liver a bit more than Gels do.

I think you have missunderstood the studies about injections when you say that they are done on supraphysiological doses of 750-1000 mg. This is not correct, the dosages are basically the same as for gels. A little simple math to prove that:

1 nebido injection is 1000 mg. Of that, 632 mg is Test (the rest is the ester). Standard protocol is one injection every 10-14 weeks so say 12 weeks on average, which means that you are delivering about 7.5 mg test per day to the body. This is about the same as you deliver with gels (e.g. standard dose tostran is 60 mg test/day of which the body on average absorbes about 12 %, equaling 7.2 mg Test).

The point is that injecting 1000 mg nebido at once never gives you supraphysiological doses and cannot be compared with e.g. injecting 1000mg enanthate at once (which indeed would give you supraphysiological levels) since the half life of test undecanoate is very very long (about 90 days). Compare that to e.g. enanthate which has a half life of about 5 -7 days.

To recap a long discussion:
Liver issues (e.g. elevated liver enzymes) on Nebido injections: Uncommon at TRT dosages, which means it is observed between 1 in 100 to 1 in 1.000 individuals.
Liver issues with gels: Very rare, which means it is observed in less than 1 in 10.000 individuals.

In comparison:
Elevetad liver enzymes on diclofenac (Voltaren) and many other OTC painkillers are observed between 1 in 10 to 1 in 100 individuals so I agree with you that injectable Test on TRT dosages are still very safe for the vast majority.

All the best.