Compounding Pharmacies and Testosterone
Compounding pharmacies can be a life saver for some guys on Hormone Replacement
Therapy (HRT). This is because both of the blockbuster HRT gels, Testim
and Androgel, don't work for all guys. Some guys could bathe in these two
drugs and still not get enough testosterone into their blood stream.
This is where a compounding pharmacy comes in. A good compounding pharmacy
takes the same bioidentical testosterone and puts into a gel or cream at the
dosage the doctor specifies. (This is generally much cheaper than either
Testim or Androgel as testosterone is a relatively cheap molecule to
manufacture.) Many guys who cannot seem to get past the 200's or 300's
with Testim or Androgel break those barriers easily with compounding.
(Most docs will try to get you right around 500 from what I have seen.)
The reasons that compounding is so much more effective are likely twofold:
the delivery system, called PLO, which is discussed below and the ability to put
as much testeosterone into the cream or gel as needed. With Androgel or
Testim, there is no variation in concentration. If you're not getting
enough testosterone, all you can do is smear on more product.
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Are there any downsides to compounding? Well, there is always the
possibility for math errors. However, in the case of testosterone, the
caclulations are quite straightforward. Most doctors will specify a
certain number of grams/day to the compounding pharmacy and so it is a simple
matter of days times grams/day for the overall quantity. The pharmacy must
also come up with the concentration for the PLO (Pluronic Lecithin Organogel),
but this is something they do quite frequently as many drugs are delivered in
What is PLO? PLO is a "penetration enhancer", i.e. it helps the drug
pass through the stratum corneum, a big name for the upper layer of your skin. PLO is usually made from soy but can be made from eggs as well. It is
composed primarily of lecithin, isopropyl palmitate and Pluronic F127.
Isopropyl palmitate helps the testosterone penetrate the skin and is also a
solvent. It can definitely cause skin irritation, clogged pores, etc. and
this is one of the potential downsides to PLO.
Pluronic F127 is a "surfactant", which means that it spreads the product out
evenly so that it does not bind or coagulate together. I have not been able to
find absorption rates nor side effects other than what I mentioned above.
These two chemicals are considered safe, but no one has tested any of this long
Realize, though, that Testim and Androgel use their own absorption system and it
may actually be similar to PLO. You can't patent a simple, "old" molecule
like testosterone, so the manufacturers actually patented their delivery system
in this case, boosting the sales price they can charge. And charge they
do: both medications are quite expensive.
The only other disadvantage that I know with compounded testosterone is that its
effect on family members is undocumented. After reports of children being
affected through their father's topical application of testosterone therapy,
the FDA asked for the manufacturers to do additional testing to make sure this
wasn't an issue with their product.
Personally, I doubt that Testim or Androgel has unusual potent penetration
capabilites as a significant percentage of guys find they get little to no
penetration. Plus, again from what I have heard, these cases are usually
from fathers who are being careless. Androgel, for example, is applied to the
chest and upper arms. Some dads go shirtless or forget to wash off the
product before doing physical things with their family.
If you thoroughly wash the area of application, your family members should be
safe, i.e. your wife and kids should not be overabsorbing supplemental
testosterone. However, you should realize that the FDA is only working
with the mainline manufacturers and not with compounding pharmacies. Talk to
your doc, of course, about all of the above. CAUTION: Be
careful about love make sessions with your woman unless you've thoroughly washed
the product off: her testosterone is just a fraction of yours!