Hi Nelson,

What is the shelf life of compounded testosterone gel? I'm getting different answers from pharmacists. For convenience and to save money, I want to order as many months as I can without the gel loosing its potency.

Also, my urologist only tests for total testosterone and PSA. When I bring up other tests, such as free testosterone, estradiol, etc., she doesn't believe it's necessary. Her nurse practitioner has said that she will discuss it with her if I can validate the need.

Being that my doctor is more conservative and selective of where the information comes from, are there any sources or studies that I can use to persuade her to order the other tests? And last, what tests would you recommend?

Thank you for your help and wishing you all the best this Holiday season and beyond!

jeff

Jeff

I would not order more than 2 month supply of compounded testosterone gel. You will not save any more money by ordering more than that and the shelf life is about 60-90 days depending on what vehicle is used.

Estradiol testing is not part of any guidelines per se, so I do not blame your doctor for resisting to do this test that costs less than $60. And most men do not need to get estradiol tested unless they have symptoms of breast swelling, pain in the nipple area, or those who seem not to be benefiting from testosterone.

Testosterone can convert into other hormones and metabolites. The process in which testosterone is converted into estrogen (a female hormone) by the aromatase enzyme is known as "aromatization". Males with high body fat, aging males, males taking certain medications, males with sex chromosome genetic conditions such as Klinefelters Syndrome or males with a genetic disposition to having higher than normal amounts of aromatase may experience higher con- version of testosterone into estrogen. Estrogen blood levels are usually measured by detecting estradiol, the main estrogen in humans. Estrogen is a very important hormone for men at the right concentration. It plays an important role in bone, hair, skin, and brain health as well as other functions in men. Large amounts of estrogen can cause mood swings, enlarged breasts (gynecomastia), fat gain, and water retention.

You may want to print these articles and give her a copy:

Dangers of Excess Estrogen In the Aging Male

and also this one specific to HIV and its medications:

Efavirenz-Associated Gynecomastia: Report of Five Cases and Review of the Literature Francisco Jover M

Arimidex for Gynecomastia Secondary to Lipodystrophy

Nelson