Hello, I have been on testosterone gel for over 3 years now (2 gel packs a day) and when I switched to a new HIV doctor (due to new insurance), he told me that the testosterone could be contributing to my lipoatrophy. For 3 months, I have only applied 1 gel pack a day, but have noticed no difference in my lipo. Also, I have so little energy that I can barely get out of bed in the morning. I desperately want to regain my quality of life and energy to live, but am torn because the testosterone may be a contributer to lipo. My VL is undetectible. What should I do?? Thank you!

It is possibly correct that testosterone supplementation may aggravate lipoatrophy, alhtough this has not been well demonstrated in clinical trials. This being said, if your free testosterone level is low, the benefits of receiving testosterone supplementation far outweighs any possible negative effects, and you should receive the supplements. I would recommend that you go ahead and get a free testosterone blood test done and then discuss the result with your doctor to discuss what to do next.