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Where to apply testosterone gel
Apr 7, 2011

Hi Nelson,

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.

Response from Mr. Vergel

Click here for original question and answer

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.

A company recently got their arm pit testosterone lotion approved to lower this transference risk.

FDA Approves First Underarm Testosterone Replacement Therapy

I hope this helps!

Nelson



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