This blog is being written mostly for those men who may be a candidate for, have tried or who are currently taking testosterone injections for low testosterone or other reasons deemed necessary by their doctor. You do need a prescription from a doctor and monitoring your treatment is necessary.
Be Wary of Men's Clinics
There are a lot of so-called men’s clinics that offer testosterone injection treatments. Maybe you’ve tried one or two of them. Each one has the same basic protocol. You typically show up to one of these clinics once a week, pay your co-pay, they give you a testosterone shot and you go on your way. You have to get follow up labs every so often as well. Hopefully, your experience has been a good one, and you are feeling much better. That is the goal. Unfortunately, there are numerous men out there who find this protocol time consuming, unreliable and very inconvenient. A more frustrating part of this protocol is that you seldom see the doctor if there is an issue. The most common complaints from this type of protocol are:
- I felt great for the first couple of months. How come all of a sudden I feel like it isn’t working anymore?
- I don’t have time to drive across town just for a shot I could probably give myself at home.
- How come I have to have my blood drawn so many times? My levels have been very consistent.
- I don’t trust the quality of the testosterone they are giving me, and I feel like it wears off too soon.
- They keep changing my dose of testosterone, and I never know how much I'm taking.
- I used to be able to give my shots to myself at home, but now they make me come in for my shot.
- They stopped taking my insurance, and now it’s costly.
- I've never seen the doctor, only a PA or a nurse. I feel like I see a new person every time I go in.
If you are wondering if there is an easier, more convenient, less expensive, more reliable way to do this there is.
TransformYou's Approach to Testosterone Replacement Therapy
Our approach is simple. We only use commercial brand name testosterone (Pfizer, Watson, West Ward), not the compounded testosterone 99% of these clinics use. It’s reliable, FDA approved, it won’t expire, and you take it home with you. You never have to wonder where your testosterone comes from and we show you how to give the shot to yourself. There will be follow up labs 5-6 weeks after you start and maybe more until we fine tune your dosage. After that, it’s every 6-12 months. If you feel great and the numbers look good, there is no need for additional labs unless you want them. We operate with a concierge-style approach; you only work with a physician, and we are always available for questions, follow-ups or consults. It’s all included. If you factor all the time and money you’ve spent going to those other clinics, our services are usually more affordable.
A Bit About Testosterone Injections
When you think of testosterone injections, whether you have tried them or not they come in an oil base. Cottonseed, grape seed, sesame, and ethyl oleate are some of the most common oils used. Let’s make one distinction before going any further though. Only commercial testosterone is produced with cottonseed oil. Commercial (brand name) is produced by bigger pharmaceutical companies and then sold to retail pharmacies like Walgreens or CVS. Compounded testosterone usually can’t be made with cottonseed oil because there are specific laws in place that say that a commercial formula can’t be replicated. So, to get around this, they change the type of oil or sometimes change the strength. The typical concentration of testosterone injections is 200mg/ml. This exact strength can be used in any of the above oils mentioned.
Compounding pharmacies make drugs prescribed by doctors for specific patients with needs that can't be met by commercially available medications at your local Walgreens or CVS. A patient may not be able to tolerate a commercially available drug, the exact preparation needed may not be commercially available, or a patient may require a medication that is currently in shortage or discontinued. These are all reasons why compounding pharmacies exist. The downside is that the regulatory oversight of pharmacy compounding is significantly less rigorous than that required for commercial pharmacies. The FDA and state regulatory agencies do have laws in place to make sure compounding pharmacies are following all the rules dealing with sterility, accuracy, quality, purity, etc. In fact, compounding pharmacies normally can’t make any drug beyond a six month or less use date. This means it expires in 6 months or less from the time it is made. This date should be on the label.
Which Type of Testosterone is Better?
So which type of testosterone is better: commercial (brand name) or compounded? Is there evidence that suggests that one is better than the other? As a matter of fact, there is. There are two studies you can feel free to read that talk about testosterone dosing accuracy, here are the links:
- Accuracy of testosterone concentrations in compounded testosterone products
- Potential risks of pharmacy compounding
The objective of the first study was to evaluate the accuracy of the testosterone concentrations within testosterone gels and creams manufactured by compounding pharmacies. The concept of accuracy, purity, and quality all apply. They asked ten pharmacies to make testosterone creams and gels at 50mg. They were to provide two samples. Not one compounding pharmacy was able to make a 50mg sample accurately. The closest one pharmacy could get was about 80% accuracy or about 40mg of testosterone. One of the ten pharmacies produced a compounded product with virtually no testosterone.
The objective of the second study was to point out that some pharmacies engage in activities that extend beyond the boundaries of traditional pharmacy compounding, such as large-scale production of compounded medications without individual patient prescriptions and creating copies of FDA-approved drugs. This can produce errors that may adversely affect many patients. Published reports of independent testing by the FDA show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved medications.
These two studies show us that there can be variability in strength and quality in what you are getting from a compounding pharmacy. Are all compounding pharmacies bad? No, not at all. Some compounding pharmacies make great hormone creams, and some don’t. Some make great injectables, and some don’t. Believe it or not, we use a few different compounding pharmacies for all the different medications we get compounded because they each make a specific medication really well that can’t be found at a retail pharmacy. We have also used compounded testosterone (years ago), but our patients were experiencing too many inconsistencies and not enough benefits. We switched to commercial (brand name) testosterone cypionate, and since then all of those inconsistencies and complaints have disappeared. We only use what will produce the best most consistent results.