AndroGel is a transdermally administered gel prescribed to men with abnormally low testosterone levels (“hypogonadism”) associated with various medical conditions. Low testosterone among men can lead to an array of unwanted effects including: cognitive impairment, decreased body hair, fatigue, fewer erections, increased body fat, low libido, and reduced muscle mass. Daily application of AndroGel has shown to safely elevate testosterone levels, thereby offsetting the cascade of deleterious health implications resulting from “low T.”
In some cases, AndroGel is also prescribed to men with low testosterone as a result of aging. Male hormones or “androgens” are thought to decline as a man enters middle age, leading to a stage tentatively referred to as “andropause” (akin to menopause for women). Though its safety and efficacy haven’t been confirmed among those with age-related hypogonadism, AndroGel is often requested by men during “andropause” to enhance vigor and libido.
Though many find AndroGel beneficial for the reversal of hypogonadism, others believe that it could increase risk of prostate cancer and heart disease. Side effects associated with AndroGel include: acne, anxiety, hair loss, headaches, mood swings, and stomach pain. As a result of these adverse effects (and/or other health risks), many AndroGel users cease treatment only to wonder how long it stays in their system following discontinuation.
How long does AndroGel stay in your system?
If you’ve fully stopped using AndroGel, you may experience some slightly disconcerting testosterone withdrawal symptoms. Upon emergence of these symptoms, you may wonder whether the AndroGel is fully eliminated from your system or whether it’ll take a long time to fully detoxify from the exogenously administered androgens. The elimination half-life of AndroGel isn’t fully elucidated, but is believed to fall within the range of 8.73 and 21.82 hours.
This suggests that it’ll take between 2 and 5 days to fully eliminate AndroGel from systemic circulation. Even among those that had attained steady state concentrations of AndroGel “1.62,” testosterone levels returned to pre-treatment baseline between 48 and 120 hours of discontinuation. Keep in mind that these figures are considered “averages” and there is often interindividual variation in regards to elimination speed.
Following transdermal absorption of AndroGel, it delivers testosterone which undergoes metabolism to form 17-keto steroids such as estradiol and dihydrotestosterone (DHT). Though in some cases metabolites may exhibit longer half-lives than the parent compound (testosterone), concentrations of estradiol and dihydrotestosterone are usually similar to that of testosterone, which has a short half-life ranging from 10 to 100 minutes. This means that the testosterone (and its metabolites) will be eliminated in under 10 hours.
The reason AndroGel isn’t eliminated in under 10 hours is due to the fact that it is delivered steadily for a period of 24 hours. Furthermore steady state concentrations of AndroGel are attained after an extended term of administration, leading to increased accumulation of androgens within the plasma. That said, most users should have fully eliminated AndroGel from their systems within 5 days of discontinuation.
- Source: http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021015s036lbl.pdf
Variables that influence how long AndroGel stays in your system
It is necessary to consider that while most people will have eliminated exogenous androgens (AndroGel) from systemic circulation within 5 days of discontinuation, there is often variance in elimination speed among users. This variance in elimination speed is usually a result of variables such as: dosage administered, term of administration, and the individual taking AndroGel. Whenever contemplating how long AndroGel may stay in your system, consider how these variables may affect elimination.
Dosage + Potency
The dosage of AndroGel that you took could affect how long it is likely to stay in your system upon discontinuation. The greater the daily dosage you administered, the longer you can expect the exogenous androgens to remain in systemic circulation. The lower the amount of AndroGel you administered per day, the quicker you can expect the exogenous androgens to get eliminated from your system.
This is due to the fact that higher doses yield greater increases in plasma concentrations of testosterone. The increased testosterone circulates throughout the system and may be subject to slight accumulation. Furthermore, higher doses will form a greater number of metabolites such as dihydrotestosterone (DHT), all of which will be subject to urinary excretion.
It is possible that metabolism of exogenous androgens, as well as their renal excretion may be less efficient at higher doses – leading to prolonged elimination. If you are a low dose user, metabolism of the exogenous androgens is likely to be quicker and renal excretion more efficient – leading to faster elimination. In addition to the dosage of AndroGel you administer on a daily basis, it is necessary to consider its potency.
AndroGel is manufactured in a “1.62%” version and a “1%” version. The “1.62%” format is considered more concentrated in that it provides a greater testosterone boost per “mg” than the “1%” format. If you are taking a high dosage of AndroGel 1.62%, chances are you’ll retain the exogenous androgens in your system for a longer duration than if you had taken an equivalent dose of AndroGel 1%.
Term of Administration
To a slight extent, the term over which you’ve been taking AndroGel may affect how long it stays in your system. If you only took it for one day, you may not have attained steady state concentrations within your plasma. Failing to attain steady state concentrations may lead to faster elimination than if you had attained a steady state of exogenous androgens (via AndroGel).
Literature suggests that it takes around 2 to 3 days to attain steady state concentrations of androgens via AndroGel. This means that if you’ve taken AndroGel for at least 3 consecutive days, you’re likely to have attained a steady state, and should experience a normative term of elimination (of around 5 days). Someone that discontinued AndroGel after a single application may eliminate the exogenous androgens in a shorter time than 5 days because they haven’t attained peak serum concentrations.
It may also be necessary to consider the fact that some users continue to increase their AndroGel dosage over a long-term. Should you have increased your dosage over a long-term, you can expect to retention of AndroGel upon cessation may also be prolonged. In addition to the term of administration, considering the frequency of application may also be necessary.
Although medical professionals will instruct users to apply AndroGel once per day, sometimes individuals may skip doses and/or ramp up the frequency of usage to 2 or 3 times per day. Should the frequency of administration increase, the total daily dosage will have also increased – leading to heightened plasma concentrations of androgens and an increased half-life. If frequency of administration decreases, steady state levels may be compromised, leading to quicker elimination.
In addition to the dosage administered, it is necessary to consider how much of the AndroGel is actually getting absorbed through the skin. If less AndroGel is getting absorbed per application, those with suboptimal absorption may clear a particular dosage from their system quicker than if they had taken steps to increase its absorption. Various factors that can affect absorption include: sites of application, co-administration of skin products, medical conditions (e.g. hypothyroidism), and showering.
- Application sites: Some data suggests that AndroGel uptake is increased when applied to sites with less subcutaneous fat (or fat under your skin). For this reason, some speculate that the sites to which you apply AndroGel may affect how much is actually absorbed. Though it is recommended to administer on shoulders and upper arms, some users administer it on other parts of their body. Administration on other sites may increase or decrease its absorption, leading to altered concentrations within the body.
- Co-administered skin products: Evidence suggests that co-administered skin products such as topical lotions, sunscreens, etc. – increase absorption of AndroGel to a slight extent. This means that you’re getting more exogenous androgens from AndroGel upon co-administration of a skin product. An increase in exogenous androgens may result in an increased half-life.
- Hypothyroidism: Conditions like hypothyroidism can impair absorption of AndroGel. Individuals with hypothyroidism experience a build-up of mucin (a glue-like substance) that causes the skin to increase in thickness. This increased skin thickness decreases absorption of AndroGel, leading to lower levels of exogenous androgens within a user’s system. These lower levels of exogenous androgens are likely to be eliminated quickly from systemic circulation.
- Showering: Users that shower within 4 hours of applying AndroGel may inadvertently decrease the amount of exogenous androgens that enter their system. This is due to the fact that showering will literally “wash off” some of the gel prior to its absorption. Reduced absorption leads to a lower level of circulating exogenous androgens, and ultimately faster elimination.
Two individuals could theoretically administer the same single dosage of AndroGel 1.62 at the exact same bodily “sites” (e.g. shoulders), yet one person may eliminate the exogenous androgens from his system quicker than the other user. Interindividual differences in the half-life of AndroGel may be due to individual factors such as: a person’s age, body mass, plasma protein concentrations, and renal function.
Age: The older the user of AndroGel, the greater the dosage that is likely to be administered to compensate for decreases in testosterone. As a result of this increased dosage, we can expect a longer elimination half-life. It is also necessary to consider the fact that age could influence hepatic and renal function, as well as plasma protein concentrations.
Elderly individuals (over the age of 65) often experience diminishing liver and kidney function, along with altered concentrations of sex-hormone binding globulin (SHBG). This may lead to increases in free testosterone concentrations, slower metabolism of exogenous androgens, and less efficient urinary excretion of metabolites. That said, the exact degree to which age may influence how long AndroGel stays in a users system isn’t fully known.
Body mass index: A person’s BMI (body mass index) may influence the absorption and disposition of AndroGel, perhaps altering pharmacokinetics to a slight extent. A massive individual with a high amount of subcutaneous fat may absorb less AndroGel than a less massive person with low subcutaneous fat. As a result of BMI-induced absorption (and possibly disposition) differences, elimination speed of AndroGel may be altered.
In addition to altering absorption and disposition of AndroGel, body mass index can also affect concentrations of SHBG (sex-hormone binding globulin). Individuals with a high BMI tend to have lower SHBG, meaning less exogenous androgens will be bound to SHBG and neutralized, leading to increases in plasma concentrations. Therefore high-BMI AndroGel users may retain the exogenous androgens for a longer duration than those with a low BMI.
Dietary intake: An individual’s dietary intake can affect their SHBG concentrations as well. Individuals (especially elderly men) eating high protein diets may experience reductions in SHBG, whereas those eating low protein diets may experience elevations in SHBG. This leads to speculation that individuals eating high protein diets may retain the exogenous androgens (from AndroGel) for a longer duration upon discontinuation than those eating lower protein.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10634401
Hepatic function: It is thought that the liver is responsible for producing a majority of sex-hormone binding globulin, which essentially binds to testosterone in the bloodstream. Among individuals with hepatic impairment, it is possible that less sex-hormone binding globulin is produced and ultimately free concentrations of exogenous androgens increase. Increased free concentrations may prolong elimination of AndroGel.
Metabolic rate: Your BMR (basal metabolic rate) could impact how long AndroGel stays in your system as well. Someone with a high BMR is known to burn more energy in a resting state than someone with a low BMR. Since individuals with high BMRs tend to metabolize exogenous drugs faster than those with lower BMRs, it is logical to hypothesize that AndroGel metabolites may be eliminated at a quicker pace among those with a high BMR.
Plasma proteins: The concentrations of SHBG (sex-hormone binding globulin) will influence the amount of free testosterone circulating throughout your system. The more SHBG you have within your plasma, the greater the extent to which androgens will be bound and rendered inactive. Lower levels of SHBG are associated with higher concentrations of free testosterone, possibly leading to an extended term of elimination. If you have higher SHBG levels, you may eliminate AndroGel quicker than a person with lower SHBG levels.
Renal function: Exogenously administered androgens are metabolized within the body and the metabolites formed undergo glucuronidation and sulfation. Glucuronides and sulfates of testosterone metabolites are then eliminated via the urine. Should an individual exhibit impaired renal function, it is possible that metabolites may accumulate and/or get reabsorbed throughout the body prior to elimination, thereby increasing the half-life of AndroGel.
AndroGel: Absorption, Metabolism, Excretion (Details)
Following transdermal application of AndroGel, testosterone is delivered for a period of 24 hours through the surface of the skin. AndroGel is hydroalcoholic and rapidly dries upon contact with the skin. The skin absorbs approximately 10% of a single “gel” dose, harboring it like a reservoir. This leads to a sustained release of androgens for a full day, increasing circulating testosterone within a normal healthy range of 298 ng/dL to 1043 ng/dL.
Most individuals experience a noticeable increase in testosterone concentrations between 30 minutes and 4 hours of administration. Steady state concentrations of AndroGel are attained within 3 days of treatment. After absorption, an estimated 40% of testosterone from AndroGel is extensively bound to sex-hormone binding globulin (SHBG), a plasma protein. A modest amount is also bound to albumin and other plasma proteins.
Only 2% of the testosterone remains in “free” (unbound) form throughout circulation. The testosterone derived from AndroGel is subject to metabolism via 17-keto steroid pathways. These metabolic pathways convert testosterone to form metabolites dihydrotestosterone (DHT) and estradiol. The concentration of DHT metabolites tends to increase in direct proportion to the dosage of AndroGel administered.
Once steady state concentrations of AndroGel are reached, its elimination half-life typically ranges between 9 and 22 hours. This implies that most users are likely to have eliminated AndroGel from their system within 5 days of discontinuation. In other words, within a week of discontinuation, an AndroGel user’s testosterone levels would have likely plummeted back to his pre-treatment baseline.
Approximately 90% of an AndroGel dosage is excreted as glucuronide and sulfate testosterone metabolites within the urine. Only around 6% of the testosterone metabolites are excreted via the feces. Most people will have excreted these metabolites in less than week of their final dose.
- Source: http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021015s036lbl.pdf
Types of AndroGel Drug Tests
Below are various types of tests that could be administered to determine levels of testosterone and metabolites. Among athletes, the most common type of test to determine artificially elevated testosterone levels is that of a urine test, but a blood sample may also be taken for confirmation. Among patients undergoing treatment for hypogonadism, testosterone levels are assessed principally with blood testing.
Urine tests: A urine test could be administered to an athlete to determine ratios of various testosterone metabolites using liquid chromatography/mass spectrometry (LC-MS) or high performance liquid chromatography (HPLC). If the ratios of testosterone metabolites fail to reflect those of what would be considered within a normative range, an athlete may be penalized and/or banned from competition. In the case of AndroGel usage, exogenous testosterone metabolites are unlikely to remain outside of the norm for an extended duration.
For accurate detection of “athletic doping” with AndroGel, an athlete would need to be assessed within several days of AndroGel administration. If a urine sample was collected after an individual had discontinued AndroGel, exogenous testosterone administration is unlikely to remain detectable. Only if testosterone esters were administered would the window of “doping” detection via a urine sample increase.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/16408923
Blood tests: A blood sample may be collected from an athlete with abnormal ratios of testosterone metabolites on a urine sample. In other cases, both blood and urine samples may be requested prior to a high-level competition. Blood tests can accurately determine whether testosterone was exogenously administered and often detects certain substances that may not appear on a urine test.
The major disadvantages associated with blood testing include: shorter detection time compared to urine tests and its invasiveness. In addition to being used to detect hormonal doping among athletes, blood testing is considered the most common way for medical professionals to accurately assess testosterone levels among patients undergoing TRT. For this reason, blood tests can accurately reveal the effects of AndroGel.
Saliva tests: Newer forms of testing involve collecting samples of oral fluid from an individual’s mouth to assess levels of testosterone metabolites. Saliva tests are an appealing option due to the fact that they are quick, non-invasive, and low cost. There are devices being developed to determine whether illicit drug metabolites and/or testosterone metabolites may be present within an individual’s oral fluid.
That said, a major pitfall associated with testosterone metabolite testing in saliva is that of inaccurate results. Research suggests that current saliva tests are too inaccurate to be adopted as a mainstream test for athletic doping. However, in future years, it is possible that technology capable of detecting testosterone metabolites in saliva may improve – which may lead to increased testing via oral fluid rather than blood and/or urine.
Who may be tested for AndroGel (exogenous androgens)?
Many AndroGel users are worried that it could cause them to fail some a work-related drug test. In reality, hormone replacement therapy won’t trigger a false positive for an illicit drug, so most people need not worry about usage of AndroGel. However, if an individual is a high level collegiate, professional, or Olympic athlete, then testing is common. Other than athletes, the only individuals subject to hormonal testing are individuals being treated with AndroGel; these tests help doctors determine whether they’re within a normal range.
- Athletes: High level athletes may apply AndroGel for an exogenous testosterone boost prior to a big game or athletic event. This may give the individual an advantage in that he/she may be less fatigued and have a greater amount of energy compared to those with less testosterone. For this reason, athletic doping agencies frequently assess athletes to determine whether testosterone (and testosterone metabolite) levels are within a healthy range.
- Medical patients: If you have hypogonadism (or low testosterone), a medical professional may collect blood samples to determine whether a prescribed treatment has elevated testosterone levels within a normative range. If testosterone levels are either “too high” or “too low” after treatment, dosage of AndroGel will be adjusted. Without actually testing levels of testosterone, it is nearly impossible to optimize circulating levels with AndroGel treatment.
Tips to clear AndroGel from your system
If you’ve discontinued AndroGel and are hoping to clear it from your system as fast as possible, you may find some of the suggestions below helpful. Prior to implementation of any of these suggestions, talk to a medical professional to verify safety and alleged efficacy. Realize that teh degree to which these tips help will likely be subject to individual variation.
- Discontinuation: The most obvious step to take if you want AndroGel out of your system is to stop using it. It can take 3 to 7 days for the exogenous androgens to metabolize and the metabolites to get eliminated (via urine and feces). Once the gel has been transdermally absorbed, most individuals should eliminate it within 5 days of discontinuation.
- Dietary modification: You may want to modify your intake of fiber and protein to alter the levels of SHBG in your plasma. SHBG (sex-hormone binding globulin) levels tend to increase when protein intake decreases and fiber intake is elevated. Increasing SHBG is known to reduce free testosterone concentrations and may therefore expedite elimination of exogenous androgens.
- Calcium-D-Glucarate: A supplement that is known to optimize the elimination of various metabolites via the kidneys is calcium-d-glucarate. This supplement acts as a beta-glucuronidase inhibitor, which essentially clears molecules that may have accumulated in detoxification pathways. Supplementation with calcium-d-glucarate could promote faster excretion of testosterone metabolites when you’ve quit AndroGel.
- Activated charcoal: A great supplement for general detoxification from any exogenous substance (drugs, hormones, etc.) is that of activated charcoal. This supplement will bind to any toxins that may have been generated by AndroGel and that could still be circulating throughout your system. Upon binding to toxins via adsorption, the charcoal will ensure that they are eliminated from systemic circulation so that you can fully detoxify.
How long has AndroGel stayed in your system after stopping?
If you’ve discontinued AndroGel, share a comment mentioning whether you were taking it for hypogonadism associated with a medical condition or age. Be sure to mention why you discontinued treatment and how long you believe it stayed in your system upon cessation. To help others understand your situation, discuss the amount you were taking on a daily basis and duration of treatment.
Do you think that AndroGel stayed in your system for over or under 5 days after your final application? Realize that for most users, exogenous androgens as attained from AndroGel are eliminated from systemic circulation approximately 5 days after discontinuation. It is unlikely that testosterone from AndroGel will have remained in your system for over a week after cessation.