Understanding and Treating Relative Androgen Deficiency in Men: Addressing Low Testosterone Levels for Optimal Health

Relative Androgen Deficiency in Men and How to Treat Low Testosterone.

Relative androgen deficiency refers to a condition where there is a lower level of androgens (male sex hormones, such as testosterone) than what is considered optimal for an individual's age and physiological needs, but not necessarily a complete deficiency. This condition can occur in both men and women, although it is more commonly discussed in the context of aging men. Often, we have patients who come to us because their primary care physician will not consider TRT for reasons like, “Your testosterone levels are within normal ranges.” or “Declining testosterone levels are normal for your age.”  

Some physicians will only treat patients if their levels fall well below traditionally low hormone ranges, but this doesn’t take into consideration the variations between individual patients as well as their potential for symptom resolution when starting hormone replacement therapy. A 30-year-old male with testosterone levels in 300’s may not fall below the reference range that labs use however they are certainly low and would benefit tremendously with treatment that optimized their hormone levels. Why is it so hard to find doctors who know this and can help men in their 30’s with Low T?

What is Relative Androgen Deficiency?

Relative androgen deficiency is a condition that describes a large portion of males who have testosterone levels that are low enough to begin experiencing some of the signs and symptoms associated with Low T but may not be below the threshold that traditional medicine deems as "below normal." This is a controversial area, as this can include both a male in their 30's and a male in their 70's and lump them together despite there being a large gap in what their hormone levels SHOULD be at for their given ages.

Age-Related Decline: As men age, testosterone levels will naturally decline. This decline can start as early as in their 20’s or 30s and continue progressively by around 1% per year. By the time a man reaches his 60s or older, their testosterone levels will usually be significantly lower compared to his levels in youth. This decline in hormones can contribute to multiple health issues, although not everyone will experience symptoms the same or even severely enough to require treatment. Often the decline is gradual, and men will just accept it as part of their “new normal” however there are steps that can be taken to reverse this process to improve overall health and wellness.

Testosterone Levels: In subclinical hypogonadism, testosterone levels are lower than what is considered normal but not significantly enough to cause clear clinical symptoms. These levels might be just below the lower limit of the normal range or fluctuate around it. Often levels are measured between 250-1000 ng/dl on most hormone panels.

Symptoms of Androgen Deficiency: Some of the symptoms associated with relative androgen deficiency (often called Low T), may include:

• Decreased Sex Drive (Low libido)
• Erectile dysfunction (ED)
• Fatigue and decreased energy levels
• Loss of lean muscle mass and overall strength
• Increased body fat, particularly around the abdomen
• Decreased bone mineral density (osteoporosis)
• Decline in cognition/brain fog
• Mood changes, like depression and/or irritability

 

Diagnosis: Diagnosing relative androgen deficiency, or Low T, typically involves several steps to get a diagnosis and prescription for testosterone from a doctor:

Clinical assessment of symptoms via physician consultation.

Blood tests that measure serum testosterone levels. It is important to measure both total testosterone and free testosterone levels (the bioavailable portion). Estradiol, a PSA, CBC, CMP, LH, FSH and SHBG may also be helpful.

Consideration of other factors that could influence testosterone levels, such as overall health, medications, lifestyle choices and comorbid conditions.

Treatment of Low Testosterone: The management of relative androgen deficiency may include:

Lifestyle changes, such as improving diet, avoiding drugs and alcohol, increasing physical activity and exercise specifically weight training, reducing stress, and increasing sleep.

Addressing any underlying health or medical conditions that may help contribute to low testosterone levels.

 Testosterone replacement therapy (TRT) might be considered for those men who have consistently low testosterone levels along with significant symptoms that impacts their quality of life. TRT should be carefully monitored by an experienced healthcare provider due to potential risks and side effects.

Considerations for Treatment of Relative Androgen Deficiency: There is ongoing debate within the medical community about the benefits and risks of testosterone replacement therapy, especially in older men. It is essential to balance the potential improvements in quality of life and symptom relief with the risks of therapy, which may include side effects. Not all physicians are experienced in the nuances of HRT and having a doctor that knows how to monitor and create a personalized protocol with proper dosing of testosterone for patients is vital for their success. There is growing mountain of scientific literature and clinical trials which show the benefits of optimal testosterone levels in men with Low T, so the interest in TRT is gaining popularity due to the potential benefits and improvements in health and wellness.

Relative androgen deficiency is a condition characterized by lower-than-optimal levels of androgens, particularly testosterone, in relation to age and individual needs. It can lead to various physical, emotional, and cognitive symptoms. Diagnosis and treatment require a comprehensive approach, including lifestyle modifications and, in some cases, hormone replacement therapy under medical supervision. To learn more about whether you may qualify for treatment, call or text NovaGenix Health and Wellness at 561-277-8260 or email us at info@novagenix.org to see how we can help treat you for relative androgen deficiency.

 

Which is Better: Testosterone Creams or Injectable Testosterone for Men on TRT

 

Comparing Testosterone Delivery Methods: Creams vs. Injections for Men undergoing Testosterone Replacement Therapy

Testosterone, the primary male sex hormone, plays a crucial role in several different bodily functions, including lean muscle growth and increased strength, bone density, libido, and mood regulation. Testosterone replacement therapy (TRT) is a common approach to address low testosterone levels in men, which can lead to several unwanted symptoms like fatigue, decreased sex drive, and loss of lean muscle mass.

Among the options for TRT, testosterone creams and injectable testosterone are two of the more popular methods of administration for patients to take. This post will talk about the differences between testosterone creams and injectable testosterone, exploring their mechanisms of action, effectiveness, convenience, side effects, and considerations for choosing one over the other for men on hormone replacement therapy.

Mechanism of Action

Testosterone creams, also known as transdermal testosterone, deliver testosterone through the skin. They typically come in gel form and are applied daily to specific areas of the body, such as the shoulders, upper arms, or abdomen. Once applied, the testosterone is absorbed through the skin into the bloodstream, where it exerts its effects throughout the body.

 

Androgel is a popular brand name testosterone gel and is a prescription medication used to treat low testosterone levels in men. It comes in the form of a gel that is applied to the skin, typically on the shoulders, upper arms, or abdomen. The active ingredient in Androgel is 1.62% testosterone, which is absorbed through the skin into the bloodstream. It's often prescribed when the body doesn't produce enough testosterone naturally, a condition known as hypogonadism. Androgel helps restore testosterone levels, which can improve symptoms such as low libido, fatigue, depression, and decreased muscle mass. It's important to use Androgel exactly as prescribed by a healthcare professional and to follow all instructions for application and dosage. Gels/creams from compounding pharmacies can have significantly higher doses of testosterone and be adjusted as needed.

On the other hand, injectable testosterone involves administering testosterone directly into the muscle tissue usually once or twice weekly. This method bypasses the skin barrier, allowing for rapid absorption and distribution throughout the body. Injectable testosterone comes in various ester forms, such as testosterone enanthate and testosterone cypionate, which dictate the release rate and duration of action.

Typically, patients use 23-25g, one-inch-long needles to administer, however this is a patient preference and can be adjusted to meet the specific needs of each individual. Compounding pharmacies can create various formulations of injectable testosterone for patients based on their specific needs. Some common types of injectable testosterone formulations made in compounding pharmacies include:

Testosterone Cypionate This is a long-acting ester of testosterone that is typically injected intramuscularly. It is often prescribed in cases of testosterone replacement therapy (TRT) and is usually administered every one to two weeks.

 

Testosterone Enanthate Similar to testosterone cypionate, testosterone enanthate is a long-acting ester of testosterone that is injected into the muscle. It has a similar dosing schedule to testosterone cypionate and is commonly used for TRT.

 

Testosterone Propionate Unlike testosterone cypionate and enanthate, testosterone propionate is a short-acting ester of testosterone. It requires more frequent injections, often every other day or every third day. It may be preferred by some individuals who want more control over their testosterone levels or who experience fewer side effects with shorter-acting formulations.

 

Testosterone Suspension Testosterone suspension is a water-based testosterone formulation that is fast-acting and short-lived. It requires frequent injections, often daily or every other day. It may be preferred by athletes or bodybuilders looking for a rapid increase in testosterone levels before competitions.

 

Testosterone Mixtures Compounding pharmacies can also create custom mixtures of different testosterone esters to meet the specific needs of patients. For example, a mixture of short-acting and long-acting esters may provide a more stable release of testosterone over time.

 

It's important to note that while compounding pharmacies can create these custom formulations, they should only do so under the supervision and prescription of a healthcare provider. Additionally, the use of compounded medications should be carefully monitored to ensure safety and efficacy.

 

Effectiveness of testosterone creams vs injectables

Both testosterone creams and injectable testosterone are effective in raising testosterone levels in men with hypogonadism or other conditions responsible for causing low testosterone. Studies have shown that both methods can improve symptoms such as low libido, fatigue, and decreased muscle mass. However, the effectiveness of each method may vary depending on individual factors such as absorption rates, metabolism, genetics, lifestyle factors and adherence to treatment protocols and physician instructions.

Injectable testosterone often leads to more consistent and predictable increases in testosterone levels compared to testosterone creams. Since it bypasses the skin barrier and directly enters the bloodstream, injectable testosterone can achieve higher peak concentrations of testosterone, resulting in more immediate effects.

Convenience

One of the primary advantages of testosterone creams is their ease of use and convenience. They can be applied at home without the need for medical supervision or special equipment, travels easily and is a good choice for patients who are terrified of self-injection. Additionally, testosterone creams allow for flexible dosing, as they can be easily adjusted by applying more or less gel as needed.

On the other hand, injectable testosterone, such as testosterone cypionate, enanthate or propionate require administration via injection, which may be a deterrent for some individuals. However, the advantage is that injectable testosterone typically requires less frequent dosing compared to testosterone creams. Depending on the ester form used, injectable testosterone may be administered weekly, bi-weekly, or even monthly, reducing the frequency of injections. Also, most patients are pleasantly surprised at how painless the injections are when a smaller needle like a 25 or 27 gauge needle is used.

 

Side Effects

Both testosterone creams and injectable testosterone can cause side effects, although the type and severity may vary between the two methods. Common side effects of testosterone therapy may include acne, increased red blood cell production (hematocrit), fluid retention and changes in mood or libido. In most cases, testosterone therapy’s risks may be mitigated with the guidance of an experienced physician who can change the protocol and offer solutions to reduce the risks associated with HRT.

Testosterone creams may carry a higher risk of skin irritation or allergic reactions due to their transdermal delivery method. Users may experience redness, itching, or irritation at the

application site. In contrast, injectable testosterone may pose a risk of injection site reactions, such as pain, swelling, or infection. When done carefully these risks are usually quite rare.

Considerations for Choosing

When considering testosterone replacement therapy, individuals should weigh the advantages and disadvantages of testosterone creams versus injectable testosterone based on their personal preferences, lifestyle, and medical needs. Testosterone creams may be preferred by those who prioritize convenience and prefer a non-invasive method of administration. However, individuals who require more precise control over testosterone levels or prefer less frequent dosing may opt for injections.

How To Buy hCG? Where can I find it Online?

How To Get hCG: Is it Available Online? What Pharmacies Still Carry Human Chorionic Gonadotropin? 

Interested in HCG therapy as part of your TRT journey? Wondering how to access it? Well, getting HCG over the counter isn't an option. In the U.S., you need a doctor's prescription, so you just can’t “Buy hCG.”. But don't worry, NovaGenix offers online consultations with certified physicians specializing in TRT. Through our telemedicine service, FDA-approved HCG can be delivered straight to your door from a licensed U.S. pharmacy. Schedule an online consultation with us today.

In recent news, on March 23rd, 2020, the FDA classified Human chorionic gonadotropin (hCG) as a "Biologic Product." This designation means that compounding pharmacies under the 503A category are no longer permitted to make HCG without a special "Biologics License." Consequently, some TRT clinics are turning to alternatives like Clomid and Gonadorelin, though they may not offer the same effectiveness or convenience as HCG.

The effectiveness of HCG lies in its ability to remain active in the body for 36-72 hours after administration. This feature makes it a popular choice among TRT patients. While some may refer to it as the "weekend pill" due to its long-lasting effects, its benefits extend beyond convenience. HCG plays a crucial role in balancing hormone levels and promoting overall well-being.

Regarding availability and pricing, pharmacies with the necessary Biologics License can still sell HCG. However, many anticipate a rise in prices due to stricter regulations. Despite these changes, NovaGenix remains committed to offering affordable treatment plans and ensuring patients receive the best possible care, and are one of the few clinics that prescribe hCG.

So, what exactly is HCG? Human chorionic gonadotropin is a hormone naturally produced during pregnancy and utilized in fertility treatments. It's also used in weight loss programs, though FDA-approved usage is limited to specific medical conditions.

As for the HCG diet, while it has been around since the 1950s, its restrictive nature has drawn criticism. As it is not FDA approved for weight loss, we cannot prescribe it for those purposes, however at NovaGenix, we offer medically supervised weight loss programs that provide more flexibility while incorporating HCG and other supplements to aid in fat loss.

The benefits of HCG extend to both men and women. For men on TRT, HCG can boost testosterone production, leading to improved energy levels, muscle mass, and overall health. Similarly, women may experience weight loss, increased energy, and improved mood with HCG therapy. In addition to HCG, NovaGenix offers a range of injectable vitamins and amino acids to support overall health and wellness. Peptides like Sermorelin, Tesamorelin and Ipamorelin can stimulate growth hormone production, while MIC injections and GAC amino acid blends aid in fat loss and muscle gain.

Furthermore, we provide essential vitamins like Vitamin D and Vitamin B12, which play crucial roles in various bodily functions, including immune health and energy metabolism.

Interested in optimizing your health with HCG therapy and other supplements? Contact NovaGenix for personalized treatment plans tailored to your needs. With our commitment to affordable care and quality service, your journey to better health starts here. We can help you get a prescription for hCG and offer all inclusive plans that are affordable, effective and convenient! Call/Text us today at 561-277-8260 to learn more.