T gel - compounding pharmacy or Androgel?

[Hughie]

Hey all, I've just received my first prescription for T today. My doctor and I decided it would be better to start on a gel to see how I react on T with a low daily dose, since I have bipolar disorder and want to keep things steady.

I'm wondering if anyone has used gel, and what their experience was like? I'm especially curious to know if anyone has used a compounding pharmacy for gel vs Androgel. Pros and cons? We started with the compounding because it's a bit cheaper. I also live near a compounding pharmacy that's supposed to be good.

Cheers!

[Elis]

Firstly  congrats:).  Secondly I've always taken testogel which comes in satchets; apart from the few times the pharmacy mistakenly given me testim. I didn't think they'd be a difference between the two as they're just different brands but while testogel dried quickly; didn't feel sticky and didn't have an overpowering alcohol smell testim was the complete opposite. So if you have the same problems best to switch brands.

Took a while to get used to putting it on everyday and being careful not to wipe any off; especially in the beginning as you're waiting for your T levels to hit a male range. But then it just becomes part of my morning routine and not a hassle.

[Kylo]

I use it and have had no problems with the type in a 60g canister. It's very easy to control your levels at any time if you need to. You have to remember not to wipe it off onto anyone or anything while still wet, and give it a couple hours before working out to allow absorption. Since I had no problems so far and it's as cheap as the shots for me where I am, I haven't switched to anything else.

[Hughie]

Cheers guys! That's great stuff to know. I'm going to call ahead to the pharmacy and see what the costs are. The guidelines here for monthly costs are $10 for injectable T and $130 for gel/patch (CDN $).

I'm hoping it's not the $130 because I don't have coverage through work till August and not sure what kind of coverage I have from my current provider, if any. This might affect when I start but at least I have the prescription! It's still sinking in that I finally have it.

My only hesitation to start now is that I'm traveling overseas for 2-3 weeks in mid-June and officially in work probation till early July when I'm back. It's a low dose, but I'm not sure when I'll be officially 'out' to everyone and there are noticeable changes. Not before July, at any rate. Any thoughts?

[FTMax]

I started on gel (Testim). There's virtually no difference between brands, compounded or not, shots vs. gel, etc. in terms of what they'll do for you. Like Elis mentioned, there are texture and smell differences that might lead you to prefer one over the other. I like the convenience of shots but my last few have been really painful due to built up scar tissue. If I can get insurance to cooperate I might cycle back to gel for a year to give my legs a break.

Do prescriptions expire there? It's been a minute since I got a new one but I feel like there is a deadline on them. Like they're void after 90 days or something. You might want to check if you're planning to wait to use it.

Low dose doesn't necessarily mean anything. I started on a low dose and had just as many changes as guys on full doses. It's all about how your body reacts to it. I'd personally wait until after I was out of a probationary period at work.

[Hughie]

I started on gel (Testim). There's virtually no difference between brands, compounded or not, shots vs. gel, etc. in terms of what they'll do for you. Like Elis mentioned, there are texture and smell differences that might lead you to prefer one over the other. I like the convenience of shots but my last few have been really painful due to built up scar tissue. If I can get insurance to cooperate I might cycle back to gel for a year to give my legs a break.

Do prescriptions expire there? It's been a minute since I got a new one but I feel like there is a deadline on them. Like they're void after 90 days or something. You might want to check if you're planning to wait to use it.

Low dose doesn't necessarily mean anything. I started on a low dose and had just as many changes as guys on full doses. It's all about how your body reacts to it. I'd personally wait until after I was out of a probationary period at work.

Cheers, that's really helpful info and insight. I believe prescriptions are ok for 6 months here but it's been a while since I've tested that. I think as long as the pharmacy has them on file before then, you can fill them later.

I'm out of the office from mid-June and back in July after the probation period ends, so I suppose I could start mid-June. At least I work for the government, so there's a union, and they have policy guidelines to support trans people, but I agree I'd rather not test it till I'm through probation.  I'll give myself a bit more time to consider the ins and outs. I've got another med test tomorrow and we'll see what the results of that are, and if it has any impact on timing.

[Hughie]

A mini update: I called a compounding pharmacy today to get an idea of the cost, but they couldn't figure it out because the prescription calls for testosterone in <Concentration> gel, with <Amount> applied daily. Can anyone make heads or tails of that?

Otherwise, I asked if there's any coverage for T, but the pharamacist said there isn't because it's a compounding pharmacy. So I'm guessing I may need to go onto the standard Androgel when I get benefits. That's interesting... when my benefits kick in from work, I think they cover 80% to a certain amount, then 100%, but I need to do a bit more research.

I'm wondering in the meantime if I have coverage from disability. I know folks from trans group in my old city who had full coverage there, so I may need to do a few calls tomorrow.

[FTMax]

Your post is going to be edited to leave the dosage out (not allowed here), but yes that makes sense - the % piece is the concentration of testosterone in the mix. For injectables, the two concentrations you'd see are 200mg/ml or 100mg/ml. That just means that there are either 200mg or 100mg of testosterone per every 1ml of fluid. So you could do the math there based on the size of the vial if you were so inclined.

The second part of yours, the ml applied daily is how much of the gel you would be applying. I always dealt with individual satchets so I'm not entirely sure how this is to be measured in a multiserve topical that isn't a pump. Androgel is a pump, so it would be however many squirts. Your doctor may tell you to use a fingernail sized amount or something like that as an easy way to measure if you were to use a compounded gel.

Personally I wouldn't get product from a pharmacy that doesn't understand how to interpret that. They likely could've cleared it up immediately by talking to your doctor.

Not sure about the coverage. IIRC, you're in Canada? So I'm not sure how that works. I know here, my insurance has a preferred pharmacy so I tend to get the highest level of coverage going there versus going to another pharmacy.

[connorlb14]

How did you get your insurance to cover your T? Mine will not. Even though my endocrinologist and my therapist prescribed it. Does it take a special request by doctors to insurance company? I am having my top surgery done this summer and will be getting birth certificate changed afterwards so I do not understand why they won't authorize this for payment by insurance. Any thoughts?

[FTMax]

How did you get your insurance to cover your T? Mine will not. Even though my endocrinologist and my therapist prescribed it. Does it take a special request by doctors to insurance company? I am having my top surgery done this summer and will be getting birth certificate changed afterwards so I do not understand why they won't authorize this for payment by insurance. Any thoughts?

My insurance will cover T in 1ml vials. You probably have a preauthorization policy on your insurance. Your doctor would need to call the preauthorization into your insurance in order for them to cover it. This is very common.

Also, instead of replying to other people's threads with off topic questions, you can make your own threads.

[Hughie]

Your post is going to be edited to leave the dosage out (not allowed here), but yes that makes sense - the % piece is the concentration of testosterone in the mix. For injectables, the two concentrations you'd see are 200mg/ml or 100mg/ml. That just means that there are either 200mg or 100mg of testosterone per every 1ml of fluid. So you could do the math there based on the size of the vial if you were so inclined.

The second part of yours, the ml applied daily is how much of the gel you would be applying. I always dealt with individual satchets so I'm not entirely sure how this is to be measured in a multiserve topical that isn't a pump. Androgel is a pump, so it would be however many squirts. Your doctor may tell you to use a fingernail sized amount or something like that as an easy way to measure if you were to use a compounded gel.

Personally I wouldn't get product from a pharmacy that doesn't understand how to interpret that. They likely could've cleared it up immediately by talking to your doctor.

Not sure about the coverage. IIRC, you're in Canada? So I'm not sure how that works. I know here, my insurance has a preferred pharmacy so I tend to get the highest level of coverage going there versus going to another pharmacy.

Cheers Max, sorry not to get back to you sooner - and no worries about the post edit. I'm going to try tomorrow to stop into the other compounding pharmacy that's supposed to be good and see what they can tell me. But if there's no insurance coverage for compounding stuff but there is for Androgel, I think I know what I'll be doing come August when work benefits kick in. I didn't have time to call today to see if the disability coverage will cover the compounding stuff right now. I'm hoping the pharmacy I see tomorrow will give me some more details.

Otherwise, I'm thinking about starting in June, to give myself more time for probation, like you suggested, and to work out the coverage logistics and other health thing. I'm off work on holiday from mid-June till my probation period ends in July, so there is that.

My 40th birthday is at the end of June and I'd really love to get started on T by then if I can. It would mean a lot.

[Hughie]

How did you get your insurance to cover your T? Mine will not. Even though my endocrinologist and my therapist prescribed it. Does it take a special request by doctors to insurance company? I am having my top surgery done this summer and will be getting birth certificate changed afterwards so I do not understand why they won't authorize this for payment by insurance. Any thoughts?

It also depends where you are in the world. I'm in Canada, and things are a bit different here, plus it varies by province and also by insurance coverage through work. Not all plans are equal. Some people do have to pay out of pocket, unless they get special paperwork filled out by their doctor (if they're on disability, for example, or limited income).