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Testocreme® provides an alternative  testosterone (T) delivery system to
supplementation by injection, patch or gel. This is a custom compound whose
formula is licensed to specific pharmacies in the USA.
 
Androgen supplementation should be considered when the anabolic effects  of
testosterone are needed to increase sexual drive, strength in wasting
conditions (HIV disease, ED, renal failure or after a critical illness or
cancer) (Tenover, 1994). Testosterone can also be used to: increase bone
mineral density in men with osteopenia or osteoporosis (Leifke, et al. 1998)
, for men on corticosteroid or narcotic therapy and for older men
experiencing andropause (Snyder, 1999; Morley, 1997).
*Androgen Guidelines
 
Androgen replacement therapy (ART) should also be considered in any
depressed men to improve mood and restore the sense of well-being. Any man
with low-normal serum testosterone levels or low salivary free testosterone
(FTs) levels plus symptoms of deficiency should be treated with supplemental
testosterone .*Androgen Guidelines (Seidman, 1998).
 
 The administration of exogenous testosterone (T) to men with abdominal
obesity has been shown to decrease fat mass (Herbst, 2000), which improves
insulin sensitivity and lowers fasting glucose levels. All adult onset
diabetics should be tested for low free testosterone levels as over one
third of diabetics are T deficient (Guay, 2006). Interestingly, testosterone
increases insulin sensitivity by increasing IGF-1 levels (Arnold, 1996).
 
Men who have problems with sexual function may apparently  have normal total
testosterone (T)  levels for their age group, but free testosterone ( FT) or
the circulating dihydrotestosterone (DHT) is a more important marker for
loss of libido and sexual arousal.*Androgen Guidelines (Carani, 1990).  Studies in France and in the US at UCLA have found that DHT used in a topical preparation (Andactrim) will reverse decreased libido in men. (deLignieres, 1993; Swerdloff, 1998).
 
 DHT and FT can be measured in serum or saliva for screening and both
provide an important part of the workup for erectile dysfunction, low libido
or anorgasmia in either sex. Patients should be informed about the low risk
of prostate enlargement or male pattern baldness with transdermals (Ly,
2001
).
 
AndroGel´® and Testim®, both 1% T products, have FDA approval as the new
standard of care for treating low T levels in men or Hypogonadism (CPT code
#257.4)
 
Caution is urged in obese men in whom excess testosterone can be converted
to estradiol ( E2) causing gynecomastia, loss of libido, increased
aggression and female body type. Some estrogen is necessary for men to
function normally sexually.
 
Free testosterone (FT) converts directly to  either DHT or estradiol (E2).
DHT is responsible for better sexual response in both men and women but at
different doses. Conversion to E2 occurs more often in obese men or if
physiologic doses are exceeded.

Monitoring free T levels provides the best indicator of testosterone
availability. Even amongst men of the same age groups, total testosterone
levels vary greatly (Plymate, 1989).

Just as women live longer and age more gracefully than men with hormone
replacement therapy (HRT), it times that men had their own testosterone
replacement therapy (TRT). (Link TRT).  It is widely accepted that in men
the quality of life,  the risk of heart disease and depression, obesity and
diabetes along with other age related changes are dependent  to some degree
on the level of testosterone. (Barrett-Connor, 1995). http://www.trials.org
Even memory in hormone deficient men will improve with
androgen replacement therapy.(ART) (Cherrier, 1998. ).

A significant portion of men with HIV infection when treated with ART,
experienced enhanced sex drive and energy, improvement in mood and increases in muscle mass. Hormone monitoring is essential to assure that physiologic levels are maintained and not exceeded.

The National Institutes of Health (NIH) have recommended that screening for
testosterone deficiency in patients reporting erectile dysfunction should be
a part of the initial exam. For some patients with an established
diagnosis of testicular failure (hypogonadism), androgen replacement therapy
may sometimes be effective in improving erectile function. Symptoms
associated with male hypogonadism include the following: impotence, and
decreased sexual desire, fatigue, and loss of energy, mood depression and
regression of secondary sexual characteristics."

AndroGel® and Testim® 1% are only the first of a line of T gels and creams
being developed for use in hormone replacement in men. DHT gels are also
being tested  in Europe as Andactrim® for the treatment of low sex drive in
older men. (Ly LP, 2001)

Our patentened product, TestoCreme®, a high potency testosterone cream (TC)
has completed clinical trials. Although this is not an FDA approved delivery
system at this time, it contains FDA approved testosterone from soybeans as
the active ingredient and is compounded by two US pharmacies.

We are looking for physicians who would be interested in trying TestoCreme®
transdermal for their patients who are not satisfied with the current low
potency testosterone gels. We  would like to familiarize you with the ease
of use and the simple monitoring of hormone levels.

If you are interested in detailed prescribing information, Please contact me
directly, by email at : DrK@WellnessMD.com.
Abraham.Kryger, MD, DMD. http://www.WellnessMD
.com

References

Tenover JS. Androgen administration to aging men. Endocrinol Metab Clin
North Am 1994;23:877-92.

Leifke E, Korner HC, Link TM, Behre HM, Peters PE, Nieschlag E. Effects of
testosterone replacement therapy on cortical and trabecular bone mineral
density, vertebral body area and paraspinal muscle area in hypogonadal men.
Eur J Endocrinol 1998;138:51-8.

Snyder PJ, Peachey H, Hannoush P, et al. Effect of testosterone treatment on
body composition and muscle strength in men over 65 years of age. J Clin
Endocrinol Metab 1999;84:2647-53.

Morley JE, Kaiser FE, Perry HM 3rd, Patrick P, Morley PM, Stauber PM, Vellas

B, Baumgartner RN, Garry PJ. Longitudinal changes in testosterone,
luteinizing hormone, and follicle-stimulating hormone in healthy older men.
Metabolism 1997 Apr;46(4):410-3

Seidman SN, Rabkin JG. Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression. J Affect Disord 1998;48:157-61.

Barrett-Connor EL. Testosterone and risk factors for cardiovascular diseases
in men. Diabete Metab 1995;21:156-61.

Carani C, Zini D, Baldini A, Della Casa, L, Ghizzani A, Marrama P. Effects
of androgen treatment in impotent men with normal and low levels of free
testosterone. Arch Sex Behav 1990;19:223-34.

de Lignieres B. Transdermal dihydrotestosterone and treatment of
"andropause". Ann Med 1993;25:235-41.

Swerdloff RS, Wang C. Dihydrotestosterone: a rationale for its use as a
non-aromatizable androgen replacement therapeutic agent. Baillieres Clin
Endocrinol Metab 1998;12:501-6.

Alexander GM, Swerdloff RS, Wang C, et al. Androgen-behavior correlations in hypogonadal men and eugonadal men. I. Mood and response to auditory sexual
stimuli. Horm Behav 1997;31:110-9.

Prehn RT.On the prevention and therapy of prostate cancer by androgen
administration. Cancer Res 1999 Sep 1;59(17):4161-4

Plymate SR, Tenover JS, Bremner WJ. Circadian variation in testosterone, sex
hormone-binding globulin, and calculated non-sex hormone-binding globulin
bound testosterone in healthy young and elderly men. J Androl 1989
Sep-Oct;10(5):366-71

Cherrier M. Testosterone supplements may improve memory in older men.
Proceedings of the 80th annual meeting of the Endocrine Society, New
Orleans, July 1998.

Swartz CM, Young MA. Low serum testosterone and myocardial infarction in
geriatric male inpatients. J Am Geriatr Soc 1987;35:39-44.

Goodyer IM, Herbert J, Tamplin A, Altham PM.First-episode major depression
in adolescents. Affective, cognitive and endocrine characteristics of risk
status and predictors of onset. Br J Psychiatry 2000 Feb;176:142-9

Arnold AM, Peralta JM, Thonney ML. Ontogeny of growth hormone, insulin-like growth factor-I, estradiol and cortisol in the growing lamb: effect of
testosterone. J Endocrinol 1996 Sep;150(3):391-9

Hardy KJ, Seckl JR.Endocrine assessment of impotence--pitfalls of measuring
serum testosterone without sex-hormone-binding globulin. Postgrad Med J 1994
Nov;70(829):836-7

Ly LP, Jimenez M, Zhuang TN, Celermajer DS, Conway AJ, Handelsman DJ.A double-blind, placebo-controlled, randomized clinical trial of transdermal
dihydrotestosterone gel on muscular strength, mobility, and quality of life
in older men with partial androgen deficiency. J Clin Endocrinol Metab 2001Sep;86(9):4078-88

 
   
   
           
           
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