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About Tostran Gel
Tostran Gel is a type of hormone replacement therapy designed for men who are affected by low testosterone levels. It can also help to treat impotence or loss of libido, once a test has been completed. Tostran Gel can be prescribed by your GP or our online doctor after an online consultation – after which you can buy it online through the Independent Pharmacy. Purchasing treatment online offers speed, convenience and discretion when seeking a resolution to your condition, with next day delivery available.
Testosterone replacement therapies are used for men who have low testosterone levels and also clinical symptoms of the deficiency. It is not for use by men who have normal levels of testosterone, as to do so could cause side-effects rather than produce any benefits.
Causes of low testosterone in a man can be a result of many things, including testicular injury, testicular cancer, an infection, a hormonal disorder, diabetes, liver or kidney problems, obesity and HIV. Low testosterone can occur in females as well as males, possibly resulting from early menopause, adrenal insufficiency, oral estrogen therapy or hypopituitarism. However, Tostran Gel is only designed for use in males.
The Process for Ordering Tostran Low Testosterone Treatment Online
If you are unable to provide three months of testosterone test results, or this is your first time with Tostran Gel, you need to follow this process:
- Choose “Tostran Gel Starter Kit”. The difference between the starter kit and the normal pack is that the starter kit contains two testosterone test kits, as these are needed to check your blood testosterone levels before, and after 3 weeks of using the treatment. The process to obtain this medication online is to complete a questionnaire then advance to the checkout process.
- Once one our UK medical team has reviewed your consultation, we will dispatch an initial test kit. We need to establish what your testosterone levels are before you start treatment to ensure your levels are outside the normal range for adult men.
- The test kits contains all you need to perform it at home and a freepost envelope to post the blood sample to the lab. Results are reported back with 4 hours of the lab receiving the sample - this is normally in 2 - 3 working days.
- Once your results have been assessed by our medical team, you will receive the result of the tests. If this therapy is not for you, your refund will be the purchase price less £35 for the price of the home testosterone kit.
- If approved, the second kit, which includes the Tostran gel and the second home testosterone test kit, will be sent to you. This test should be completed three weeks after you receive the testosterone treatment and results are taken to ensure that, for health and safety reasons, the medication is taking effect.
These first two tests will be performed in the first month, with the next test being taken after six months and then at yearly intervals after that.
What is included in the Tostran Starter Pack?
Two home testosterone test kits. Conducted with ease in the comfort of your own home, one test is to be completed before treatment commences and the other, if the test is approved, is to be completed after three weeks of treatment. Each blood test costs £35 and it is your decision both as to whether to take the second test and whether to continue with the treatment.
Containing testosterone, a male hormone, you apply the clear Tostran gel to your skin on your shoulders and/or upper arms), from where testosterone is absorbed into your bloodstream, to help raise your testosterone to normal levels.
In a condition known as hypogonadism, a man does not produce sufficient levels of natural testosterone to produce sperm, or to maintain the male characteristics of body hair and a deep voice. Tostran gel helps increase levels of testosterone and helps maintain both a normal sex drive and sexual function, as well as maintain muscle strength and size. As a result, he will naturally produce more sperm.
Tostran gel comes in a 60g canister and the piston emits doses of a half a gram of gel, which contains 10mg of testosterone. Before using it for the first time, press the piston about 8 times, to get it ready for use and discard any gel which escapes during this priming of the piston.
The gel should be applied on clean and dry skin, alternating daily between sharing the dose between the inner thighs, or applying it to the abdomen and never to the genitals. Apply the gel gently and do not wash that area of skin for at least 6 hours, as doing so would reduce the amount of gel available for absorption into the skin.
The normal recommended daily dose it 6 depressions of the canister pump, which will deliver 3g of gel (60mg of testosterone). While a doctor may sometimes recommend a higher daily dose which will relate to your general health, it should never exceed 8 depressions, which would amount to 4g of gel (80mg of testosterone).
Once applied, smooth the gel very gently into your skin and wait until it is fully absorbed, before washing your hands and then dressing. This application takes only a few minutes.
Testim gel and Testogel are two other products which contain the same active ingredient.
Do not use Tostran if you suffer or suspect you suffer from prostate cancer, breast cancer or are allergic to any of the ingredients.
Keep out of the reach and sight of children.
Take care and inform your doctor if: you have difficulties passing water, liver, kidney or heart disease, have high calcium levels, high blood pressure, suffer from migraines, suffer from heart or lung disease.
Do not use Tostran: If you:
- are allergic to testosterone or any of the other ingredients of this medicine
- have or are suspected of having cancer of the breast or prostate
If any of these apply to you, tell your doctor or pharmacist.
Warnings and precautions:
A check-up is necessary before you begin treatment, and periodically during treatment (usually once or twice a year).
If you are suffering from severe heart, liver or kidney disease, treatment with Tostran may cause severe complications in the form of water retention in your body sometimes accompanied by (congestive) heart failure.
The following blood checks should be carried out by your doctor before and during the treatment: testosterone blood level, full blood count.
Tell your doctor if you have high blood pressure or if you are treated for high blood pressure, as testosterone may cause a rise in blood pressure.
Testosterone treatment may increase the risk of development of an enlarged prostate gland (benign prostatic hyperplasia) or prostate cancer. Testosterone treatment may also affect the number of red blood cells you have, your blood fat profile and your liver function.
Tell your doctor before treatment if you:
- have swollen hands and feet
- are overweight or suffer from a chronic lung disease, as testosterone treatment may worsen sleep apnoea (temporary cessation of breathing during sleep)
- have diabetes and use insulin to control your blood sugar levels, as testosterone treatment may affect your response to insulin
- have or develop epilepsy or migraines, as these conditions may get worse during treatment
- suffer from skeletal cancer, as your doctor will have to monitor your blood calcium levels during treatment
- have or have ever had blood clotting problems
- thrombophilia (an abnormality of blood coagulation that increases the risk of thrombosis blood clots in blood vessels)
- factors that increase your risk for blood clots in a vein: previous blood clots in a vein; smoking; obesity; cancer; immobility; if one of your immediate family has had a blood clot in the leg, lung or other organ at a young age (e.g. below the age of about 50); or as you get older.
- How to recognise a blood clot: painful swelling of one leg or sudden change in colour of the skin e.g. turning pale, red or blue, sudden breathlessness, sudden unexplained cough which may bring up blood; or sudden chest pain, severe light headedness or dizziness, severe pain in your stomach, sudden loss of vision. Seek urgent medical attention if you experience one of these symptoms.
Contact your doctor if you:
- have frequently-occurring or persistent erections
- feel irritable, nervous, or notice weight gain
- feel nauseous, vomit, notice changes in your skin colour or your ankle joints become swollen
- notice any changes in breathing patterns including during sleep
These symptoms may mean that your dose of Tostran is too high, and your doctor may need to adjust your dose.
Contact your doctor if you notice any skin reactions at the site of application such as burning or prickling sensation, dryness, rash, redness or itchiness. If the reaction is severe, treatment should be reviewed by your doctor and stopped if necessary.
If you are an athlete please note that Tostran contains testosterone, which may give positive results in a doping test.
Tostran should not be used to treat male sterility or sexual impotence.
Tostran should not be used by women due to possible virilising effects (such as growth of facial or body hair, deepening of the voice or changes in the menstrual cycle).
How to prevent transfer of Tostran to someone else:
It is important not to transfer the product to others, especially women and children. Transfer occurs through close skin to skin contact, resulting in increased testosterone levels in the other person. If the contact is repeated or prolonged, it may cause side-effects such as growth of facial or body hair, deepening of the voice or changes in the menstrual cycle of women.
This transfer can be avoided by covering the application site with loose clothing, or by showering or bathing prior to contact.
The following precautions are therefore recommended:
- wash your hands thoroughly with soap and water after applying the gel;
- cover the application site with loose clothing once the gel has dried;
- shower or bathe before any situation involving close skin to skin contact with someone else.
In order to guarantee the safety of your partner you should wait for at least four hours after application of Tostran before having sexual intercourse and wear clothing which covers the application site at the time of contact or wash the site of application with soap and water before sexual intercourse.
You should wear clothing which covers the application site when in contact with children in order to avoid the risk of transferring the gel to the child’s skin.
If you transfer some of the testosterone gel to another person by skin-to-skin contact, or someone else is exposed by direct contact with the gel itself, wash the contact area of the other person with soap and water as soon as possible.
If Tostran is applied to a patient by a health care professional or carer, they should wear suitable disposable gloves. The gloves should be resistant to alcohol as the gel contains ethanol and isopropyl alcohol.
Contact your doctor if you notice changes in body hair, significantly increased acne or other signs of development of male characteristics in people not being treated with Tostran (i.e., female partner or children).
Other medicines and Tostran:
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, especially the following:
Also tell your doctor or pharmacist about any medicines that you may have bought for yourself without prescription.
Tostran with food and drink:
Tostran is not affected by your intake of food or drink.
Pregnancy and breast-feeding
- Tostran is only intended to be used by men.
- Tostran must not be used by pregnant or breastfeeding women.
- Pregnant women should avoid all contact with skin treated with Tostran. Tostran may cause harm or abnormalities in the unborn baby. If your partner becomes pregnant, you must follow the advice regarding avoiding transfer of the testosterone gel given in this section. In the event of contact with treated skin, the area should be washed immediately with soap and water.
Driving and using machines:
Tostran is unlikely to have an effect on your ability to drive and use machines. Tostran contains butylhydroxytoluene and propylene glycol Butylhydroxytoluene may cause local skin reactions (e.g. contact dermatitis) or irritation of the eyes and mucous membranes. This medicine contains up to 1400 mg propylene glycol in each dosage unit which is equivalent to 350 mg/g.
Apply Tostran Gel only to healthy, normal skin. Never apply Tostran Gel to your genitals (penis and testes) or to skin that is broken or damaged and avoid contact with open sores, wounds or irritations.
Apply Tostran Gel at the same time each day (preferably every morning). Apply the contents (or as directed by your GP) on the shoulders and/or upper arms every morning, as instructed by your doctor.
If you take a bath or shower in the morning, use Tostran Gel after your bath or shower. Make sure that your shoulders and/or upper arms are clean and completely dry before putting on the gel.
Apply Tostran Gel only to your shoulders and/or upper arms as a thin layer. In this way your body will absorb the right amount of testosterone. Use a circular motion to rub the gel into your skin for several seconds. Do this until completely absorbed.
Thoroughly wash your hands with soap and water immediately after application. This will also reduce the chance that the medicine will spread from your hands to other people. Let Tostran Gel dry for a few minutes before you dress. This prevents your clothing from wiping the gel off your skin and ensures that your body will absorb the correct amount of testosterone.
If you wash the application site within 6 hours after applying Tostran Gel you may lower the amount of testosterone that is absorbed by your body. Therefore, wait at least 6 hours after applying the gel before showering or swimming to ensure that the greatest amount of Tostran Gel is absorbed into your body.
The active substance is testosterone. One gram of gel contains 20 mg of testosterone.
The other ingredients are propylene glycol; ethanol, anhydrous; isopropyl alcohol; oleic acid; carbomer 1382; trolamine; butylhydroxytoluene (E321), water, purified and hydrochloric acid (for pH adjustment).
Tostran side effects
Like all medicines, Tostran can cause side effects, although not everybody gets them.
Very common side effects (affects more than 1 user in 10) are: skin reactions at the site of application such as burning or prickling sensation, dryness, rash, redness or itchiness. These are usually mild transient side effects of Tostran but if they are troublesome or last for more than a few days, talk to your doctor or pharmacist as soon as possible.
Common side effects (affects 1 to 10 users in 100) are: swelling of hands or feet, high blood pressure, prostate changes (including: increased blood levels of a protein called prostate specific antigen that is produced by the prostate), increased body hair growth, increase in breast size, increased number of red blood cells (measured in blood samples). Increase in red blood cell count, haematocrit (percentage of red blood cells in blood) and haemoglobin (the component of red blood cells that carries oxygen), identified by periodic blood tests.
For a full list of possible side effects, please read the Patient Information Leaflet.
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Tostran Gel FAQs
Hypogonadism can also indicate other health issues which affect testosterone levels and so the treatment has three main aims:
- Treat any underlying conditions
- Restore testosterone levels, via Testosterone Replacement Therapy
- Improve hypogonadism symptoms, such as low libido, erectile dysfunction and other symptoms.
Low testosterone is also found in 60% of obese men.
Skin contact can cause the gel to be transferred to someone else and they could experience side-effects, even if contact was in an isolated area of skin but over a long period of time. Take care in the cases of children or pregnant women, by washing your hands fairly rigorously and covering the skin where the gel has been applied. In the case of sexual activity, always shower first. All of this information will be given in the product leaflet which comes with the medication.
After the doctor has checked that the medication is right for you, you will receive the test kit in the post. The pack contains everything you need to take a blood sample, which you will post to the laboratory in the pre-paid envelope provided.
They are processed on the day of receipt and results are sent to you electronically.
While one test is for testosterone levels, a test may be needed of your prostate (PSA), if this has not been examined in the past. The test kit received may be to check both testosterone and prostate and these can both be done from one blood sample.
PSA (prostate specific antigen) is a protein which is produced by both normal and cancer cells in the prostate and the PSA test measures the quantity of this protein in your blood. The amount of this protein increases with age and this can cause the prostate to increase in size, so the test is simply to check the health of the prostate and is not necessarily looking for cancer. This test can be done at any surgery and the result can be discussed with the practice nurse.
The PSA test is a guide and the result, together with information you provide via a consultation, helps decide whether testosterone treatment is the right way ahead for you.
If there is a raised PSA level, this could indicate:
- An enlarged prostate
- Prostate cancer.
These are not the only health conditions which can be identified from a PSA test and so there are times when you may be referred to a hospital specialist for further information. This information is important in deciding whether testosterone therapy can be given as, if the person does have prostate cancer, it is important to keep testosterone levels as low as possible and not to increase the levels via this therapy.
A raised PSA level does not mean that you have prostate cancer, as prostate cancer can also be found in men who have low PSA counts. The likelihood of having prostate cancer rises if:
- Your father or your brother has had it
- Your are over 50 years of age
- You are black.
Deciding if you should see a specialist is not based solely on your PSA level but on the above points and also if you have been for a prostate biopsy in the past. A digital rectal examination (DRE) can also be done, to assess if your prostate feels normal.
Whilst it is normal to have a small amount of prostate specific antigen (PSA) in your blood, this level does increase with age, with prostate problems (prostatitis or an enlarged prostate) and also with:
- Medicines - some medicines can affect your PSA level, so let your doctor or nurse know if you are taking any prescription or over the counter medicines. Some medicines for an enlarged prostate can reduce your true level of PSA and therefore give false readings. These medicines include 5-alpha-reductase inhibitors (e.g. dutasteride (Avodart) and finasteride (Proscar)).
- Ejaculation - advice may be given to avoid any form of sexual activity which culminates in ejaculation for the 48 hours which precede a PSA test.
- Prostate stimulation and anal sex - stimulation of the prostate and also anal sex can cause your PSA level to rise, so it is best to be clear of such stimulation for at least seven days before your PSA test.
- A urine infection - if you have a urine infection, this will need to be treated and cleared first, as this can give a false reading to a PSA test. The period in between clearing the urine infection and having a PSA test should be about six weeks.
- Digital rectal examination (DRE) - if you have had a digital rectal examination, your doctor will advise that you wait a week before having a PSA test, as the DRE can also raise PSA levels.
- Vigorous exercise - avoid any rigorous exercise for about 48 hours before a PSA test, as this can also affect your PSA level.
- Prostate biopsy - a prostate biopsy within six weeks of a PSA test could also raise your PSA level.
- Other tests or surgery - any tests or surgery on your prostate or your bladder, or if you have had needed a catheter, could also affect a PSA level reading, so you will be asked to wait six weeks before a PSA test is done.
Taking a PSA test comes with both advantages and disadvantages:
- Men who are more at risk of prostate cancer (e.g. their father or a brother has experienced this condition), will be able to have any changes in their PSA level detected
- Prostate cancer can be identified, even before any symptoms present themselves. If picked up early enough, treatment may be able to prevent its spread.
- A PSA test doesn’t always pick up prostate cancer
- Following a PSA test up with a biopsy may cause some side-effects e.g. an infection in urine, semen and blood, as well as cause pain
- A slow-developing prostate cancer may be identified but such cancers may not shorten your lifespan and so identification simply brings about stress and worry
- Treatments for prostate cancer can also cause erection problems.
Then we would recommend you see your own doctor for further tests. Our doctors will advise on the next steps when your results come back.
Only by knowing your testosterone level can we decide if this treatment is right for you. You then have to wait three weeks for the medication to be fully absorbed into your system, so that a future test can tell if your levels have indeed increased.
Different treatments are applied to different areas of the body:
- Coming in pump dispenser form, tostran is applied to the shoulders and abdomen.
- Coming in tube format, Testim and Testogel are applied to the upper arm and the shoulders.
While there should be an improvement with your PSA level within 3 weeks, the level reached depends on your starting level, which would have been identified with the PSA test.
We are available to answer any queries, at no obligation to yourself.
Some bodybuilders claim that ‘ectomorphs have low testosterone’ and suggest using Tostran Gel to artificially enhance testosterone levels. We do not recommend using Tostran Gel for this purpose – our online doctor will only prescribe the treatment to someone who genuinely has low testosterone levels that require treatment.
Obesity is one of the risk factors for men having lower than normal levels of testosterone. Low testosterone has also been linked to weight gain in some cases – so it can sometimes become a vicious circle. While balding is a natural part of aging for most men, those with low testosterone may experience a more rapid loss of body and facial hair.
Low testosterone levels can lead to many symptoms, including loss of sex drive, increased body fat, lack of motivation and sleep problems. All of this can, understandably, leave the sufferer feeling physically and mentally tired. If you suspect you have low testosterone, complete an online consultation to find out whether Tostran Gel could be an appropriate treatment for you.
Testosterone levels naturally decrease as men age. In men younger than 50, there may be other reasons behind it, which could include cancer radiation treatment, HIV, pituitary gland tumours, diabetes, or being very overweight. Tostran Gel can be prescribed to males over the age of 18.
Low testosterone can affect a man’s health in other areas, especially his sex life, since he may have trouble maintaining an erection. It’s a common condition in men as they start to get older. Sometimes, low testosterone can have some more serious long-term effects on the body, in particular, an increased risk of osteoporosis. Low testosterone has also been connected to high blood pressure, diabetes and metabolic syndrome, but it isn’t thought to cause these problems, and replacing testosterone will not necessarily cure them. There’s currently no evidence of a link to cancer.
Testosterone is important for sperm production. Naturally, some of the symptoms of low testosterone – such as low libido and erectile dysfunction – can impact a man’s fertility. Normal sperm production will usually resume once the condition has been addressed with testosterone treatments.