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The Best Low T Medication — Injections Still Better Than Creams, Pellets

If you’re suffering from the symptoms common to low testosterone and clinical testing has indicated that Low T is actually the source of your trouble, you’re probably looking into testosterone replacement therapy, and you’ve probably found right away that the plethora of Low T medications on the market can be confusing.

There’s a lot of information out there to sift through, not to mention all the gimmicky marketing.

We’d like to help.

Low T medications, like the pills, injections, creams, and other options pictured here, all have different benefits and drawbacks. Learn which medication is right for you.

A healthy and factual understanding of available types of Low T medication can prepare you for a constructive conversation with your medical provider about which form of supplementary testosterone might be right for you.

Low T Medication and the Goal of TRT

The first objective of TRT is to raise testosterone levels into a normal range, but the overall goal is to improve the symptoms associated with that proven deficiency and to keep those levels there.

When you receive a dose of supplemental testosterone, your body absorbs, metabolizes, and utilizes the hormone, and this causes levels to fluctuate — the levels rise, the symptoms are eased, and you stay stable for a short period of time. Then, unless levels are restored, the free testosterone in your bloodstream will be further metabolized (eventually into inactive metabolites), and your symptoms will return.

The challenge is to keep your testosterone levels in the optimal range — not too high, not too low — and that requires frequent administration of properly dosed Low T medication in one form or another and is only achieved with expert management.

Every method of delivering that supplemental testosterone compound has advantages and disadvantages that present themselves over the course of treatment.

The Most Reliable Low T Medication Choice — Injections

The Low T medication that medical providers have preferred for decades is called testosterone cypionate, delivered by means of intramuscular injection. The compound dissolves into the bloodstream over the course of several days.

With injections, your levels will elevate and plateau at about 48 hours, and then gradually decline over the coming days.

To stay within the “optimal” range for your body, you’ll need an injection on day 7 to restore levels and prevent them from dropping out of the desired range.

This schedule of injections is still the most accurate and consistent method on the market when it comes to keeping your levels within proper limits while addressing symptoms.

The Advantages of Testosterone Injections

Testosterone injections have long been the go-to method of delivery for the following reasons:

  • They provide the most accurate dosing possible
  • They have a lower chance of resulting in levels that are too high or that drop too low for too long
  • There is no chance of accidentally getting the medication into the body of someone that it’s not meant for (like your partner or children)

The Disadvantages of Testosterone Cypionate

The primary drawback to testosterone injections is that they have to be administered every week. While better than creams (which are administered daily), once a week can still be a difficult schedule to keep.

A secondary drawback is the fact that you must be injected — some patients hate needles and would prefer to avoid them.

Correct dosing and proper timing are critical to successful treatment, and that often means a visit to a TRT clinic like Testosterone Centers of Texas is required every 7 days.

Some patients initially see those weekly visits to the clinic an inconvenient disruption to their weekly activities, but with our dedication to providing phenomenal care with efficiency in mind, they quickly find this to be of little impact to their schedule.

Topicals, Creams, Gels, Patches

Let’s discuss topicals — this category includes all the methods of delivery that involve absorption through the skin (called transdermal), such as gels, creams, and patches.

It seems simple and convenient in theory, but the disadvantages are significant.

The Upside of Topicals

The main reason patients choose topical medications is the ease of administration — no needles.

Available by prescription from your medical provider, you pick up this Low T medication at your pharmacy and apply it daily to the skin on your shoulders and upper arms after showering.

Again, it’s really simple in concept, but the drawbacks are concerning.

The Serious Downside

The first negative is that topicals don’t work for everyone — some men receive little or no benefit from topical methods of delivering supplemental testosterone.

Another problem is that topicals are expensive — they are not covered by many medical insurance providers or insurance plans.

Yet another issue is that some men develop a rash to the areas where the topical Low T medication is applied.

But the most serious drawback is that a topical Low T medication can be transmitted to another person by physical contact — adding testosterone to the system of your partner or your child can be harmful to their health.

(Click here to read a scholarly article containing a lot of information on transdermal and sublingual testosterone.)

Sublingual Testosterone Hits Your Bloodstream too Quickly

Sublingual Low T medication is held under the tongue or between the gums and cheek so it can be absorbed into the bloodstream through the mucous membranes that line your mouth.

The Plus Side

Similar to the topicals above, it’s convenient.

Sublingual testosterone is absorbed the quickest of all forms, and it causes an almost immediate spike in levels. (But, that’s not really a positive thing when we look deeper.)

The Minuses

What comes up must go down — levels rise quickly, and they fall quickly.

That means fatigue, irritability, and low mood can come and go in frequent peaks and valleys.

Results for absorption of sublingual testosterone also vary widely from person to person.

These spikes in hormone levels are known to be hard on the liver, as well. Any patients with a history of liver problems need to avoid this form of testosterone delivery.

There’s just too much up and down going on to feel comfortable with the safety of this form of Low T medication, which is why we never recommend sublingual testosterone at Testosterone Centers of Texas.

The Most Popular Form of Low T Medication — Testosterone Pellets

Finally, there are hardened pellets that are implanted under the skin, intended to stay in your body for 4–6 months.

Pellet Positives

Again, it’s convenience.

Also, it’s impossible to forget to take this form of Low T medication since it’s an implant. In theory, it takes care of itself.

The Negatives

Not only are pellets often left unpaid by insurance, they simply aren’t nearly as reliable as advertised.

There’s a short period of high testosterone levels that’s followed by a 3-4 month slide towards the threshold of experiencing low testosterone symptoms again — this pattern simply isn’t as stable as injections.

And, that’s not all. The following are additional problems patients have with pellet implants:

  • The need for surgical implantation
  • Infection at the point of implantation
  • Pellet extrusion (Your body may discharge the pellet)
  • Poor absorption and performance for some patients

In other words, they can be a much bigger pain than the tiny prick of testosterone injections.

Injections Remain the Ideal Method of Testosterone Replacement Therapy

There’s really not much comparison — when it comes to testosterone replacement therapy and the different methods of administering supplemental testosterone, injections still do the job better than any other method available.

Out of the 4 families of Low T medication covered in this article, injections are the most reliable and have the least probability of harmful side effects. When it comes to Low T medication, cost is a factor as well — injections are also quite affordable, especially compared to topicals.

Injections safely raise your testosterone levels to the normal range and stabilize them — if you’re having your medical provider administer the medication, those weekly visits to the clinic allow for frequent, scheduled testing to minimize any risk of side effects.

Click the button below to learn more about the benefits of injections for TRT patients.


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Glenn Steponaitis, PA-C

Glenn Steponaitis, PA-C began his healthcare career nearly 20 years ago as a medical technician at Seton Medical Center while concurrently earning a Bachelor of Arts degree in Biology at the University of Texas in Austin.   His interest in medicine lead him down the path of becoming a certified Physician Assistant and achieving a Bachelor of Science degree in this field from the University of Texas Southwestern Medical Center at Dallas.   Following completion of his schooling, Glenn started a 10 year career in the field of Gastroenterology and Hepatology, and in 2010 he began focusing on the medical management of those suffering from symptoms caused by low testosterone after witnessing hormone replacement doctors help Low T sufferers.

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