Dr. Tracy Gapin and Dave Asprey rank testosterone delivery methods. Injections win for stable levels and ease, requiring just two to three shots weekly with a fine needle. Topical creams work but need daily application to absorbent areas and risk exposing partners or kids.
I want to go through a list of ways that I know of to get testosterone into the body, and I want you to rank these and tell me the pros and cons.
Okay?
Sure. Here's the master list of testosterone delivery mechanisms for us. We have nasal spray, which I'm about to try.
Don't ever prescribe that. Have not tried that myself.
I'm excited. It's in the mail.
I'll have to hear about that.
We have testosterone pills now, testosterone undecanoate is what it's called. We have testosterone creams. We have injectable testosterone of different forms. We'll get into that. And then we have testosterone pellets.
Sure.
Okay. That's a long list. Yeah. How the heck do I know what to do? Yeah.
So every man's different, personalized. Have to have a conversation with your doctor. All that aside, in general, injections are what I would recommend as the best way to go for most men. And the reason why I like injections, I do it myself personally as well, is that you can maintain consistent levels without having to deal with the hassle of daily treatment. And so we can do injections twice a week, three times a week, you know, ideally be every day, but that's a little intrusive and the compliance is going to go down. So typically, twice a week, three times a week is a great interval. And with that, you can get to a nice steady state where your levels are exactly where you want to be. So that you can test your level anytime during that cycle. And you know that you're at a steady state, have the same level. And so I love injections. It's easy. You can do either subcutaneous injection in the belly. You could do intramuscular injection either in the thigh or the buttock or have someone do it in the arm. Most men prefer subcutaneous injections. It's painless. You can't even feel it. You're using like a 27, 28 gauge insulin needle that you can't even feel. And so I love subcutaneous injection as the primary best option to start testosterone. Intramuscular is great as well. Some men, we're talking 2, 3% of men with sub Q injections, they won't get their levels up to where you need them. Again, that's very rare, 2 to 3%. Otherwise, you can switch to intramuscular as the next option. Topical is a great choice as well. And when we do topical, we don't use the prescription pharmaceutical gels, which can never get your levels up to where you need to be.
Gels don't work.
You know, typically use like a versa based compound of cream, put them on the scrotum every morning. And why the scrotum? The absorption on the scrotum is infinitely better than anywhere else in the body.
It also makes more DHT on the scrotum.
It does more gc, unfortunately, which can rarely be an issue.
Well, it might be good for you.
It might be good, yeah.
So for the creams, it's scrotum, then perineum, then armpits would be the most absorbable area anywhere.
Those, those spots would be great. Most guys do in the scrotum. The whole issue with touching your partner. Testosterone is actually great for women, as I know you've talked about before as well. So it's really more concern with children. You want to be sure that once you apply it, wash your hands, especially before you touch the kids.
I actually think if you have young kids especially, you shouldn't use testosterone. Testosterone cream, even if it's on your sheets and they touch it, they don't need very much in order to really have strong effects. I went off cream when I started having children in the house and switched to injections to protect the kids. Yeah. Also I never loved having kind of oily balls. What do you do about that?
You just wait for it to dry. But it is for some guys a nuisance. And you have to do it every morning. So the half life is so short with topical that if you put it on this morning, by tomorrow it's gone. And so you have to do it every day. And for some guys, it's the compliance factor is what prohibits that. So I put that lower than injections in terms of what I would recommend. Pellets go below that. And the reason why I don't recommend pellets is the same experience that you described where levels can be all over the place. And for years back in my urology days, I would put in 15 pellets in a guy and his levels would go, his total would go from 300 to 800 this time or 300 to 1600 next time with no clear reason why. The levels vary so much. And absorption and metabolism varied so much with pellets that I kind of veered away from them. For some men who are maybe traveling overseas or who, who don't want to carry them with them, you know, the injectable, maybe there's a reason for pellets, but in general, injections are easy and quick and painless and much better option than pellets.
Okay. Yeah.
