Personally, I believe Androgel is a useless product. Using more will likely dry out your skin as it is alcohol based. Based on many blood tests that I have seen, I do not think it elevates the levels of total or free testosterone in the blood in a meaningful manner even for just "replacement therapy." I think it was the puritanical anti steroid medical community's answer to how to get around giving someone an injectible anabolic agent for a valid medical reason. So they gave you a gel packet and condescendingly told you rub it on just before bedtime and oh! golly gee! it really contains 5 grams of testosterone in each packet so you are actually getting quite a lot of testosterone--NOT!! They choose to forget to tell you that the skin is a remarkably effective barrier (first line of defense) against absorbing anything into the body, androgel INCLUDED. I have seen it maybe raise blood testosterone levels (total) by 50 to 100 points at most (and I am being exceedingly generous here) which still sucks if you are only at 107 ng/dl total testosterone (I am assuming your 107 was total as if that were free, you would be extremely high and nobody would prescribe you anything!!!).
Ok, so let's do the math, 107 + 100 = 207 which is still WELL below the BOTTOM of the normal range of 300 - 1100 ng/dl for total testosterone!!! I hate to say it but there are six year old girls that have more than 107 ng/dl testosterone in all likelihood. Hmmm, somehow that doesn't conjure up much of an image of huge shredded beef! If your doc is THAT conservative, then you need to find someone a bit, shall we say, more enlightened. Your own blood work alone would be excellent documentation to obtain LEGAL INJECTIBLE testosterone that MIGHT even get paid for by your insurance company. But once again, here, many insurance companies do not like covering self injectibles for some stupid reason........do I suspect that we haven't progressed at all from the Puritanical reasoning that pervades this country since time zero. Sort of makes you wonder the dilema they will go through once FDA approves the new T-20 fusion inhibitor which is likey to be a daily sub-q self injection for HIV treatment. Of course, with the enormous amount of hypocrasy in this country, I am sure that they'll come up with some other dumb or dumber reason not to cover one kind of self injectible but cover another--of course, we can't say the "A" word (anabolic) now can we?
Did your doc learn enough in medical school to question the REASON that your testosterone is SO low? He could have tested your LH and FSH levels for instance to determine the cause and then try to find a decent solution. Let's say that you have 107 ng/dl testosterone total but your levels of LH are twice or three times normal........hmmmm.......what does this say?......It says that your brain is SCREAMING at your Leydig cells to make MORE testosterone but it ain't happening! So the obvious conclusion is that the problem lies in the Leydig cells of the testes themselves. This is true of approximately half of the people that are hypogonadal with HIV. The ONLY option to correct this situation is injectible testosterone. There are NO other viable solutions. He doesn't have to worry about DEA because it is valid for a valid medical purpose which is medically documented by YOUR blood work. It is also not only just about valid "replacement" but it is also about preserving and promoting lean mass gain in people that are HIV positive as the lean mass has a strong correlation with quality of life and survival with the disease and hey, if you get some extra beef from it, who can complain about that? It will also correct several serious metabolic problems typical with HIV disease or does your doc not know this either?
The other option is that if your LH and FSH are zero. This could be because of HIV disease (this accounts for the remaining approximately one half of hypogonadal HIV+ men) OR it could be a result of PRIOR use of INJECTIBLE androgens. Only you know this. If the levels of LH and FSH are zero then your doc could quite justifiably prescribe you HCG (Human Chorionic Gonadotropin) in an "off label use" to mimic the action of the LH and tell your Leydig cells to get to work! If, after follow up blood testing, this does not bring the levels high enough, he should then ADD injectible testosterone to the mix. The HCG will also have the effect of "leveling out" the peaks and valleys between the shots so it has a lot of value in keeping the levels more consistent for this purpose. Just a couple of things to think about. Remember, don't be afraid to fire your doc if he won't work for your best interests/health, there are plenty of others that will and would LOVE to collect your insurance money as well!!! Don't kid yourself! I hope this helps.
But the REAL question is, is there any way of isolating the testosterone from the gel matrix and solvent in androgel and turning it into an injectible product?
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