Which Testosterone Replacement Therapy is the Best?
Millions of American men suffer from symptoms attributable to low testosterone to include fatigue, decreased libido, erectile dysfunction, depression, anemia, and decreased muscle mass and bone density. As such, they are turning to Testosterone Replacement Therapy to help improve their quality of life.
Testosterone Replacement Therapy (TRT) is a method of treatment for men who have low levels of testosterone. TRT works by using testosterone to replace the hormones that the body is no longer producing in adequate amounts. This therapy has been studied and proven to be beneficial for helping improve symptoms such as fatigue, obesity, low sex drive, depression, and even weak bones. TRT has been shown to help improve energy levels, muscle mass, and overall psychological health. It can even strengthen the immune system and help with weight loss.
As the medical community slowly (very slowly) starts to recognize the life-changing effects TRT can have on men who need it, more forms of TRT are becoming available.
This leads us to question, which form of TRT is best?
Currently, the following preparations are available for TRT:
· Testosterone Gels
· Injections
· Patches
· Buccal Cavity (gums/cheek)
· Nasal
· Pellets
A case for injections:
Based on personal experience and research, I believe that injectable forms of TRT are superior to any other currently available form for most men.
For one, it’s more potent. Studies consistently show that gains in strength and other musculoskeletal benefits are greater when using injectables.
Secondly, although contrary to what many believe, injectable testosterone is safer than topically applied forms.
Why is injecting testosterone safer than applying a gel?
Many of the side effects from TRT such as hair loss or even potential cardiovascular risks aren’t actually from testosterone but from a by-product of testosterone – Dihydrotestosterone (DHT).
The enzyme 5a-reductase converts testosterone into DHT. There are high concentrations of 5a-reductase in our skin. So, when you apply testosterone directly to the skin, there is going to be a higher and unnatural increase in DHT.
This may explain why the studies that do link cardiovascular disease to TRT are almost always using a testosterone gel, and that studies that show cardiovascular benefit are typically using injections.
There is also the inconvenience of having to apply the topical forms daily in order to maintain testosterone levels and the risk of your testosterone getting on your kids … or your spouse … I’m sure she wouldn’t be too happy about that.
Testosterone Pellets
Testosterone pellets involve men undergoing a procedure in which an incision is made at the hip and pellets are placed under the skin.
This is an attractive option to some because they usually last around 90 days and don’t involve any self-application/injections.
However, while this is a very minor procedure, it’s still a surgical procedure and one that you’ll be doing 4x/year so there are risks involved.
Additionally, once the pellets are in … they’re in. If the dose isn’t working, you’ll typically have to wait the 90 days before you can adjust the dose.
Injections for the Win
Based on available data, it’s clear that injectable testosterone is superior to other forms. When testosterone in injected subcutaneously at smaller bi-weekly doses, it’s very effective and has an excellent safety profile. This is what I personally use and what I prescribe to my patients.
